MEDICARE: MATTHEW JOSEPH COWAN

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	225XP0200X	Pediatric Occupational Therapist	OC017850	PA
2	225X00000X	Occupational Therapist	026768	NY
3	225X00000X	Occupational Therapist	OC017850	PA

General Provider Information

NPI Number	:	1124792775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW JOSEPH COWAN

Provider Business Mailing Address
First Line	:	PO BOX 92
Second Line	:
City	:	BROOKLYN
State	:	PA
Zip	:	18813-0092
Country	:	US
Telephone Number	:	570-877-3076
Fax Number	:

Provider Business Practice Location Address
First Line	:	1355 LAKELAND DR
Second Line	:
City	:	SCOTT TOWNSHIP
State	:	PA
Zip	:	18433-7814
Country	:	US
Telephone Number	:	570-254-9485
Fax Number	:	570-254-6730

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

Provider Enumeration Date	:	08/06/2021
Last Update Date	:	12/15/2025

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Directions to “ MATTHEW JOSEPH COWAN ” Practice Location

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