Provider Demographics
NPI:1366427346
Name:CAVEROW, MATTHEW (MPT)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:CAVEROW
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:189 5TH AVE
Mailing Address - City:ESTELL MANOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08319-0068
Mailing Address - Country:US
Mailing Address - Phone:609-476-2946
Mailing Address - Fax:
Practice Address - Street 1:118 WHEAT RD
Practice Address - Street 2:
Practice Address - City:BUENA
Practice Address - State:NJ
Practice Address - Zip Code:08310-1402
Practice Address - Country:US
Practice Address - Phone:856-697-3071
Practice Address - Fax:856-697-3370
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01086000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist