Provider Demographics
NPI:1780935320
Name:GIULIANO, MATTHEW PAUL (PT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:PAUL
Last Name:GIULIANO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2417 E 53RD ST
Mailing Address - Street 2:SUITE100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-6600
Mailing Address - Country:US
Mailing Address - Phone:205-259-3991
Mailing Address - Fax:
Practice Address - Street 1:3202 S MEMORIAL DR STE 9
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-1323
Practice Address - Country:US
Practice Address - Phone:918-280-0180
Practice Address - Fax:918-280-0170
Is Sole Proprietor?:No
Enumeration Date:2012-09-22
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4589225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOKA106011Medicare PIN