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NPI 1932656527

NPI 1932656527 : MATTHEW KATTELL : BINGHAMTON, NY

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General NPI Number Information
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    NPI Number           |    1932656527
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    Entity Type          |    Individual 
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    Provider Name        |    MATTHEW KATTELL
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/01/2016
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    Last Update Date     |    05/01/2025
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Provider Practice Location Address
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    Address Line         |    249 GLENWOOD RD 
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    City                 |    BINGHAMTON
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    State                |    NY
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    Zip                  |    13905-1603
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    Country              |    US
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    Telephone            |    607-240-4828
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    249 GLENWOOD RD 
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    City                 |    BINGHAMTON
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    State                |    NY
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    Zip                  |    13905-1603
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    Country              |    US
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    Telephone            |    607-240-4828
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    Fax                  |    518-583-7606
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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       |    040782
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    License Number State |    NY
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