Healthcare Provider Details

I. General information

NPI: 1164352670
Provider Name (Legal Business Name): MATTHEW DELFICO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 WESTCHESTER AVE # G02
WEST HARRISON NY
10604-2906
US

IV. Provider business mailing address

637 COVE RD UNIT B10
STAMFORD CT
06902-5403
US

V. Phone/Fax

Practice location:
  • Phone: 914-681-1116
  • Fax:
Mailing address:
  • Phone: 914-325-3155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number049845-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: