Healthcare Provider Details

I. General information

NPI: 1639316359
Provider Name (Legal Business Name): MATTHEW PINTO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2009
Last Update Date: 01/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2925 HAMBURG ST
SCHENECTADY NY
12303-4343
US

IV. Provider business mailing address

2925 HAMBURG ST
SCHENECTADY NY
12303-4343
US

V. Phone/Fax

Practice location:
  • Phone: 518-357-2909
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number276400000X
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: