# MR. MATTHEW DAVID PULLANO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1619040425
- **Gender:** Man
- **Credential:** PT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 017307-1 | NY | — |
| 225100000X | Physical Therapist | 10183 | SC | Yes |

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 04/22/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000021582 | BCBS | NY |
| 01 | — | 10035643-J508 | CDPHP | NY |
| 01 | — | 200486570 | COMP, RMSCO, CIGNA | NY |
| 01 | — | 438500 | MVP | NY |
| 01 | — | 5392510 | AETNA | NY |
| 01 | — | 816782 | GHI & MPN | NY |