Basic Information
| Provider Information | |||||||||
| NPI: | 1902018906 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MATTEO | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50 BEECH DRIVE | ||||||||
| Address2: | |||||||||
| City: | NORRISTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194035421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102796100 | ||||||||
| FaxNumber: | 6102790978 | ||||||||
| Practice Location | |||||||||
| Address1: | 50 BEECH DRIVE | ||||||||
| Address2: | |||||||||
| City: | NORRISTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194035421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102796100 | ||||||||
| FaxNumber: | 6102790978 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PS016184 | PA | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.