Provider Demographics
NPI:1902809866
Name:MATTLEMAN, STEVEN J (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:MATTLEMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9501 ROOSEVELT BLVD
Mailing Address - Street 2:STE 305
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-1028
Mailing Address - Country:US
Mailing Address - Phone:215-671-4280
Mailing Address - Fax:215-464-9034
Practice Address - Street 1:261 OLD YORK RD
Practice Address - Street 2:STE 214
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3706
Practice Address - Country:US
Practice Address - Phone:215-885-4700
Practice Address - Fax:215-885-6861
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2008-02-08
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Provider Licenses
StateLicense IDTaxonomies
PAMD024530E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011731600007Medicaid
PA430197NYVMedicare ID - Type Unspecified
PA0011731600007Medicaid