Healthcare Provider Details

I. General information

NPI: 1326280645
Provider Name (Legal Business Name): MATTHEW DOUNEL M.D. M.P.H
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22215 NORTHERN BLVD STE LOBBYA
BAYSIDE NY
11361-3678
US

IV. Provider business mailing address

72-11 AUSTIN ST MB #230
FOREST HILLS NY
11375
US

V. Phone/Fax

Practice location:
  • Phone: 718-405-8410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number266098
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number266098
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: