Healthcare Provider Details

I. General information

NPI: 1285911685
Provider Name (Legal Business Name): MATTHEW ALTI RPA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2011
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4295 HEMPSTEAD TURNPIKE
BETHPAGE NY
11714
US

IV. Provider business mailing address

36 VISTA LN
LEVITTOWN NY
11756-2646
US

V. Phone/Fax

Practice location:
  • Phone: 516-520-2676
  • Fax:
Mailing address:
  • Phone: 516-287-5229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number015288
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number015288
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: