Individual
MATTHEW JOHN PONTORIERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
125 DAUGHERTY DR, SUITE 301, MONROEVILLE, PA 15146-2749
(412) 856-4666
Mailing address
125 DAUGHERTY DR, SUITE 301, MONROEVILLE, PA 15146-2749
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA0585891
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022213
PTAN
PA
01
—
1073880597
SS
PA
01
—
1598758138
DB
PA
01
—
1750429130
AA
PA
01
—
41798MV2
AA PTAN
PA
01
—
A0009876100009
AA MEDICAL ASSISTANCE
PA
Enumeration date
10/03/2016
Last updated
10/03/2016
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