MEDICARE: MATTHEW NALBANDIAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	210651	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013901842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW NALBANDIAN M.D.

Provider Business Mailing Address
First Line	:	48 BI-STATE PLAZA
Second Line	:	#225
City	:	OLD TAPPAN
State	:	NJ
Zip	:	07675-7079
Country	:	US
Telephone Number	:	212-254-6882
Fax Number	:	212-254-6886

Provider Business Practice Location Address
First Line	:	48 BI STATE PLZ # 225
Second Line	:
City	:	OLD TAPPAN
State	:	NJ
Zip	:	07675-7003
Country	:	US
Telephone Number	:	212-254-6882
Fax Number	:	212-254-6886

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	02/03/2017

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