Matthew Staback, DPT
Physical Therapist in Middletown, NY. Individual provider (NPI-1).
NPI number1649791518
StatusActive
Last updated in NPPESMar 31, 2022
Details
- NPI
- 1649791518
- Entity type
- Individual (NPI-1)
- Name
- Matthew Staback
- Credential
- DPT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 30, 2017
- Certification date
- Mar 31, 2022
- Last updated
- Mar 31, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 048606 | NY | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – |
Practice location
1219 Dolsontown RdMiddletown, NY 10940-4749
Phone 845-344-1899
Mailing address
111 Maltese DrMiddletown, NY 10940-2141
Phone 845-342-4774
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