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General NPI Number Information
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NPI Number | 1568408334
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Entity Type | Individual
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Provider Name | MATTHEW PETER LOREI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 3401 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-5103
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Country | US
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Telephone | 215-707-2111
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Fax | 215-707-2324
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Provider Business Mailing Address
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Address Line | 2450 W HUNTING PARK AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19129-1302
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Country | US
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Telephone | 215-707-2111
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Fax | 215-707-2324
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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 | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | MD065103L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 0420011055
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License Number State | VT
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