Individual
MR. MATTHEW C ACKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
90-02 QUEENS BLVD, ELMHURST, NY 11373
(718) 558-1000
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
164570
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01068900
—
NY
01
—
0133867
GHI
NY
01
—
1926T1
BCBS
NY
01
—
1926T2
EMPIRE BCBS
NY
01
—
P00388301
RAILROAD MEDICARE
CA
Enumeration date
07/25/2006
Last updated
12/13/2007
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