Provider Demographics
NPI:1477173755
Name:JAVITT, MATTHEW JACOB (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JACOB
Last Name:JAVITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8300 TWIN FORKS LN
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4847
Mailing Address - Country:US
Mailing Address - Phone:301-830-2917
Mailing Address - Fax:
Practice Address - Street 1:243 CHARLES ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3096
Practice Address - Country:US
Practice Address - Phone:617-573-3689
Practice Address - Fax:617-573-6965
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-16
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1018597207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology