Basic Information
| Provider Information | |||||||||
| NPI: | 1689061020 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BIERNAT | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | MATEUSZ | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 416457 | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022416457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8443621735 | ||||||||
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| Practice Location | |||||||||
| Address1: | 225 MILLBURN AVE STE 303 | ||||||||
| Address2: | |||||||||
| City: | MILLBURN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070411712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9739127273 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2015 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 25MA10058400 | NJ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.