Provider Demographics
NPI:1942541917
Name:STAY, MATTHEW A (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:A
Last Name:STAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 NATIONAL PIKE W
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15417-9221
Mailing Address - Country:US
Mailing Address - Phone:724-785-7633
Mailing Address - Fax:
Practice Address - Street 1:565 NATIONAL PIKE W
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15417-9221
Practice Address - Country:US
Practice Address - Phone:724-785-7633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010714111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA271802YGCIMedicare PIN