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NPI Code Detail

MEDICARE: MR. MATTHEW CHARLES ALESSI P.T.

MEDICARE: MR. MATTHEW CHARLES ALESSI P.T.
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
1225100000XPhysical Therapist020133-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
19312369OTHERNYINDEPENDENT HEALTH
2000625810002OTHERNYCOMMUNITY BLUE
300011197201OTHERNYUNIVERA

General Provider Information

NPI Number : 1376518498
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATTHEW CHARLES ALESSI P.T.
Provider Business Mailing Address
First Line : 3925 SHERIDAN DR
Second Line : SUITE 110
City : AMHERST
State : NY
Zip : 14226-1738
Country : US
Telephone Number : 716-250-6500
Fax Number : 716-250-4177
Provider Business Practice Location Address
First Line : 3925 SHERIDAN DR
Second Line : SUITE 110
City : AMHERST
State : NY
Zip : 14226-1738
Country : US
Telephone Number : 716-250-6500
Fax Number : 716-250-4177
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2006
Last Update Date : 12/22/2009

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