Provider Demographics
NPI:1831808872
Name:MATTE, DAN (ATC)
Entity type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:MATTE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:DR
Other - First Name:DAN
Other - Middle Name:
Other - Last Name:MATTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ATC
Mailing Address - Street 1:145 INGRAHAM BLVD
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-5835
Mailing Address - Country:US
Mailing Address - Phone:516-729-8262
Mailing Address - Fax:
Practice Address - Street 1:145 INGRAHAM BLVD
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-5835
Practice Address - Country:US
Practice Address - Phone:516-729-8262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000647-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer