Basic Information
Provider Information
NPI: 1831396357
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TORMENTI
FirstName: MATTHEW
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
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Mailing Information
Address1: 1203 LANGHORNE NEWTOWN RD
Address2: SUITE 138
City: LANGHORNE
State: PA
PostalCode: 190471209
CountryCode: US
TelephoneNumber: 2157413141
FaxNumber: 2157413125
Practice Location
Address1: 901 W MAIN ST
Address2: SUITE 267
City: FREEHOLD
State: NJ
PostalCode: 077282537
CountryCode: US
TelephoneNumber: 7323338702
FaxNumber: 7323338703
Other Information
ProviderEnumerationDate: 06/28/2007
LastUpdateDate: 05/27/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/27/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000XMA092542NJY Allopathic & Osteopathic PhysiciansNeurological Surgery 
207T00000XMD447907PAN Allopathic & Osteopathic PhysiciansNeurological Surgery 

No ID Information.


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