Provider Demographics
NPI:1588689855
Name:NESTER, MATTHEW J (DPM)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:NESTER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3227 LONG BEACH RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-3651
Mailing Address - Country:US
Mailing Address - Phone:516-431-1600
Mailing Address - Fax:516-431-5743
Practice Address - Street 1:3227 LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-3651
Practice Address - Country:US
Practice Address - Phone:516-431-1600
Practice Address - Fax:516-431-5743
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005466213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN005466OtherHIP/HEALTHCARE PARTNERS
NYP2000724OtherOXFORD
NY01987342Medicaid
NY04091400038OtherFIDELIS
NY1499685OtherGHI
NYPG6013OtherEMPIRE BLUE CROSS/BLUE SH
NY1000031683OtherAFFINITY
NYU76903Medicare UPIN
NY01987342Medicaid
NY04091400038OtherFIDELIS