MEDICARE: DR. MATTHEW JOHN MCREE PT

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	10126	NC
2	225100000X	Physical Therapist	0310961	NY

General Provider Information

NPI Number	:	1619098738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW JOHN MCREE PT

Provider Business Mailing Address
First Line	:	228 W 71ST ST
Second Line	:	APT 2D
City	:	NEW YORK
State	:	NY
Zip	:	10023-3730
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3435 DEKALB AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2301
Country	:	US
Telephone Number	:	718-547-8899
Fax Number	:

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

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	06/13/2010

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