Provider Demographics
NPI:1205123866
Name:MCGUIGAN, MATTHEW PATRICK (OD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:PATRICK
Last Name:MCGUIGAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 HARDING HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-2243
Mailing Address - Country:US
Mailing Address - Phone:609-833-4430
Mailing Address - Fax:609-277-2067
Practice Address - Street 1:5401 HARDING HWY STE 2
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-2243
Practice Address - Country:US
Practice Address - Phone:609-833-4430
Practice Address - Fax:609-277-2067
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00693200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1026407440001Medicaid