Provider Demographics
NPI:1831952589
Name:MATTHEW P J TITMUSS DPT PLLC
Entity type:Organization
Organization Name:MATTHEW P J TITMUSS DPT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:PETER JOSEPH
Authorized Official - Last Name:TITMUSS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:212-203-2671
Mailing Address - Street 1:3117 BROADWAY APT 60
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-4660
Mailing Address - Country:US
Mailing Address - Phone:212-203-2671
Mailing Address - Fax:
Practice Address - Street 1:3117 BROADWAY APT 60
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4660
Practice Address - Country:US
Practice Address - Phone:212-203-2671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty