Provider Demographics
NPI:1780412023
Name:BECAN, MATTHEW REID (COF)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:REID
Last Name:BECAN
Suffix:
Gender:M
Credentials:COF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 S ALLENTOWN RD
Mailing Address - Street 2:
Mailing Address - City:TELFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18969-1307
Mailing Address - Country:US
Mailing Address - Phone:610-844-7586
Mailing Address - Fax:215-723-5176
Practice Address - Street 1:154 S ALLENTOWN RD
Practice Address - Street 2:
Practice Address - City:TELFORD
Practice Address - State:PA
Practice Address - Zip Code:18969-1307
Practice Address - Country:US
Practice Address - Phone:610-844-7586
Practice Address - Fax:215-723-5176
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOF000058225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter