# MATTHEW ALEXANDER BEVACQUA

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

## Provider details

- **NPI number:** 1619358439
- **Gender:** Man
- **Credential:** DPT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 047378 | NY | — |
| 225100000X | Physical Therapist | 13136 | CT | — |
| 225100000X | Physical Therapist | 25503 | MD | Yes |
| 225100000X | Physical Therapist | 25535 | MA | — |
| 225100000X | Physical Therapist | 40QA02019100 | NJ | — |
| 225100000X | Physical Therapist | 5501301792 | MI | — |
| 225100000X | Physical Therapist | J1-0014396 | DE | — |
| 225100000X | Physical Therapist | PT03402 | RI | — |
| 225100000X | Physical Therapist | PT200001236 | DC | — |
| 225100000X | Physical Therapist | PT5966 | ME | — |

## Other

- **Enumeration date:** 06/17/2015
- **Last updated:** 03/03/2022