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1194023309
GARY C MATTHESEN
WHITESTONE, NY
NPI
1194023309
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
Additional Taxonomies
174400000X Specialist
(Licence: NY 387-1)
Enumeration Date
2011-03-11
Last Update Date
2019-02-20
Business Address
Mr. GARY C MATTHESEN MPA OTR
15050 14TH RD
WHITESTONE, NY 11357-2609
Phone number: 718-767-0091
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Mailing Address
Mr. GARY C MATTHESEN MPA OTR
2832 ROYLE ST
BELLMORE, NY 11710-4131
Phone number: 516-679-8553
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