Provider Demographics
NPI:1124032727
Name:ALBERT, MATTHEW (PT, MSPT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:ALBERT
Suffix:
Gender:M
Credentials:PT, MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 STATE RT 23
Mailing Address - Street 2:SUITE 15B
Mailing Address - City:RIVERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07457-1603
Mailing Address - Country:US
Mailing Address - Phone:973-400-1716
Mailing Address - Fax:973-513-9882
Practice Address - Street 1:44 STATE RT 23
Practice Address - Street 2:SUITE 15B
Practice Address - City:RIVERDALE
Practice Address - State:NJ
Practice Address - Zip Code:07457-1603
Practice Address - Country:US
Practice Address - Phone:973-400-1716
Practice Address - Fax:973-513-9882
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00943700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2131865OtherUNITED HEALTHCARE
NJ7313851001OtherCIGNA PPO
NJ2131865OtherUNITED HEALTHCARE