Provider Demographics
NPI:1376835124
Name:WACHTLER, MATTHEW FRANCIS (DPM)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:FRANCIS
Last Name:WACHTLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:882 POMPTON AVE STE B1
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-1256
Mailing Address - Country:US
Mailing Address - Phone:973-857-1184
Mailing Address - Fax:973-857-3114
Practice Address - Street 1:882 POMPTON AVE STE B1
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-1256
Practice Address - Country:US
Practice Address - Phone:973-857-1184
Practice Address - Fax:973-857-3114
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00314900213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery