Provider Demographics
NPI:1194892687
Name:MATTHEW J. PITERA, M.D, P.A
Entity type:Organization
Organization Name:MATTHEW J. PITERA, M.D, P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PITERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-244-6626
Mailing Address - Street 1:222 OAK AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3348
Mailing Address - Country:US
Mailing Address - Phone:732-244-6626
Mailing Address - Fax:732-244-6623
Practice Address - Street 1:222 OAK AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-3348
Practice Address - Country:US
Practice Address - Phone:732-244-6626
Practice Address - Fax:732-244-6623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA596052084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty