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General NPI Number Information
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NPI Number | 1225992100
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Entity Type | Individual
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Provider Name | MATTHEW KROON
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Gender | Male
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Dates
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Enumeration Date | 12/15/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 1441 SOUTH AVE BLDG SUITE SUITE 704
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3779
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Country | US
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Telephone | 718-303-9777
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Fax | 718-303-9778
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Provider Business Mailing Address
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Address Line | 8 COLLEGE AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10314-2418
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Country | US
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Telephone | 718-303-9777
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Fax | 718-303-9778
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 055499
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License Number State | NY
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