Provider Demographics
NPI:1477684991
Name:PORTADIN, MATTHEW ANDREW (PSYD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ANDREW
Last Name:PORTADIN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 COCASSET ST STE 3
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2996
Mailing Address - Country:US
Mailing Address - Phone:856-701-5586
Mailing Address - Fax:888-585-0916
Practice Address - Street 1:21 COCASSET ST STE 3
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2996
Practice Address - Country:US
Practice Address - Phone:856-701-5586
Practice Address - Fax:888-585-0916
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist