Individual
MR. CRAIG ISAO MATSUMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
900 OLD MARPLE RD, SPRINGFIELD, PA 19064-1211
(610) 328-1166
(610) 328-2023
Mailing address
1 STAFFORD PL, SEWELL, NJ 08080-2548
(856) 228-2114
(610) 328-2023
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
009075-1
NY
363A00000X
Physician Assistant
25MP00086700
NJ
363A00000X
Physician Assistant
Primary
MA0002698-L
PA
Other
Enumeration date
02/02/2010
Last updated
02/02/2010
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