Healthcare Provider Details

I. General information

NPI: 1154230225
Provider Name (Legal Business Name): MATTHEW HOLLANDER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 BROADWAY RM 204
NEW YORK NY
10001-7504
US

IV. Provider business mailing address

636 STERLING PL APT 3R
BROOKLYN NY
11238-4880
US

V. Phone/Fax

Practice location:
  • Phone: 646-535-1298
  • Fax:
Mailing address:
  • Phone: 917-687-9327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP145599
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: