| Doctor Name: | MATTHEW MARUCCI |
| NPI Number: | 1699829341 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSPT, OCS, CSCS |
| License Number: | 027064-1 |
| Business Practice Address: | 16 Schuman Rd Millwood, NY - 105461111 |
| Business Phone Number: | 9144885440 |
| Business Fax Number: | |
| Mailing Address: | 16 Schuman Rd, MILLWOOD |
| State: | NY |
| Postal Code: | 105461111 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/22/2007 |
| NPI Last Update Date: | 07/12/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251S0007X |
| License Number: | 027064-1 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Sports |
| Taxonomy Definition: | |