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General NPI Number Information
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NPI Number | 1386368728
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Entity Type | Individual
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Provider Name | JOSHUA LINDLEY MATEO
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Gender | Male
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Dates
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Enumeration Date | 09/29/2022
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 1350 WESTFALL RD
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City | ROCHESTER
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State | NY
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Zip | 14618-2790
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Country | US
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Telephone | 877-407-3422
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Fax | 877-407-4329
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Provider Business Mailing Address
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Address Line | 9712 63RD DR APT 3A
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City | REGO PARK
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State | NY
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Zip | 11374-2244
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Country | US
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Telephone | 310-997-6338
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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 | 048722-01
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License Number State | NY
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