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General NPI Number Information
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NPI Number | 1629631437
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Entity Type | Individual
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Provider Name | MATTHEW BERTINATO DPT
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Gender | Male
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 801 ELKTON BLVD STE 3
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City | ELKTON
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State | MD
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Zip | 21921-5342
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Country | US
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Telephone | 201-873-8079
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Fax |
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Provider Business Mailing Address
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Address Line | 41 SENTRY LN
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City | NEWARK
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State | DE
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Zip | 19711-6959
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Country | US
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Telephone | 201-873-8079
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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 | J1-0003233
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License Number State | DE
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