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General NPI Number Information
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NPI Number | 1477684991
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Entity Type | Individual
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Provider Name | MATTHEW ANDREW PORTADIN PSY.D
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Gender | Male
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 21 COCASSET ST STE 3
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City | FOXBORO
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State | MA
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Zip | 02035-2996
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Country | US
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Telephone | 856-701-5586
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Fax | 888-585-0916
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Provider Business Mailing Address
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Address Line | 21 COCASSET ST STE 3
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City | FOXBORO
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State | MA
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Zip | 02035-2996
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Country | US
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Telephone | 856-701-5586
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Fax | 888-585-0916
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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