National Provider Identifier
Matthew Profeta, PT
Matthew Profeta, PT is listed in the NPPES registry with a primary specialty of Physical Therapist in Kenmore, NY and a listed phone number of (716) 423-2262.
Profile Overview
- NPI
- 1720476245
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- January 06, 2015
- Last Updated
- April 14, 2021
Practice Location
- 2760 Delaware Ave
- Kenmore, NY 14217-2702
Phone: (716) 423-2262
Mailing Address
- Box 8000 Dept 314
- Buffalo, NY 14267-0002
Specialties
- Physical Therapist (225100000X)
- Physical Therapist (225100000X)
Full Record
- NPI
- 1720476245
- Entity Type
- Individual
- Last Name
- Profeta
- First Name
- Matthew
- Credential
- PT
- Mailing Street Address
- Box 8000 Dept 314
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14267-0002
- Mailing Country
- US
- Mailing Phone
- (716) 213-0772
- Mailing Fax
- (716) 324-5004
- Practice Street Address
- 2760 Delaware Ave
- Practice City
- Kenmore
- Practice State
- NY
- Practice ZIP Code
- 14217-2702
- Practice Country
- US
- Practice Phone
- (716) 423-2262
- Practice Fax
- (716) 423-2263
- Enumeration Date
- January 06, 2015
- Last Updated
- April 14, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- April 14, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X), Physical Therapist (225100000X)
- Other Identifiers
- 04425389 (NY)