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General NPI Number Information
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NPI Number | 1033306907
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Entity Type | Organization
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Legal Business Name | PASQUALE J. DEMATTEO, D.O., P.C.
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 525 TUNXIS HILL CUT OFF
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City | FAIRFIELD
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State | CT
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Zip | 06825-4447
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Country | US
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Telephone | 203-384-2273
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Fax | 203-384-1235
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Provider Business Mailing Address
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Address Line | 525 TUNXIS HILL CUT OFF
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City | FAIRFIELD
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State | CT
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Zip | 06825-4447
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Country | US
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Telephone | 203-384-2273
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Fax | 203-384-1235
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PASQUALE JOSEPH DEMATTEO
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Credential | D.O.
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Telephone | 203-384-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 000-200
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License Number State | CT
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