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General NPI Number Information
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NPI Number | 1235252917
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Entity Type | Individual
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Provider Name | MATTHEW CONOSCENTI PT
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Gender | Male
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 2600 EASTON RD
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City | WILLOW GROVE
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State | PA
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Zip | 19090-1010
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Country | US
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Telephone | 610-768-1663
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 34990
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City | BELFAST
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State | ME
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Zip | 04915-0627
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Country | US
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Telephone |
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Fax |
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251H1200X
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Taxonomy Name | Hand Physical Therapist
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License Number | PT009367L
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License Number State | PA
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