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Individual

TERENCE MATALON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5501 OLD YORK RD, LEVY GRD FL, PHILADELPHIA, PA 19141-3018
(215) 456-6200
(215) 456-8996
Mailing address
101 E OLNEY AVE, SUITE 400, PHILADELPHIA, PA 19120-2421
(215) 456-7000
(215) 254-2599

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD422226
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01966202
PA
Enumeration date
10/04/2006
Last updated
10/19/2011
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