Organization Name: | MATT HOSSEINI DPM PHD INC |
NPI Number: | 1215240940 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MATT HOSSEINI (CEO) |
Mailing Address: | 2728 E Main St Millville |
State: | NJ US |
Postal Code: | 083329638 |
Phone Number: | 8568257331 |
Fax Number: | 8568257512 |
NPI Enumeration Date: | 07/22/2010 |
NPI Last Update Date: | 07/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 25MD00252900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |