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Individual

MR. GARY C MATTHESEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MPA OTR

Contact information

Practice address
15050 14TH RD, WHITESTONE, NY 11357-2609
(718) 767-0091
Mailing address
2832 ROYLE ST, BELLMORE, NY 11710-4131
(516) 679-8553

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
387-1
NY
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
03/11/2011
Last updated
02/20/2019
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