MEDICARE: DR. MATTHEW PETER JOSEPH TITMUSS DPT

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	225100000X	Physical Therapist	031870	NY

General Provider Information

NPI Number	:	1124340450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW PETER JOSEPH TITMUSS DPT

Provider Business Mailing Address
First Line	:	3117 BROADWAY APT 60
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-4660
Country	:	US
Telephone Number	:	212-203-2671
Fax Number	:

Provider Business Practice Location Address
First Line	:	3117 BROADWAY APT 60
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-4660
Country	:	US
Telephone Number	:	212-203-2671
Fax Number	:

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

Provider Enumeration Date	:	03/01/2010
Last Update Date	:	02/05/2024

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