Provider Demographics
NPI:1417958604
Name:CONIGLIARI, MATTHEW FRANCIS (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:FRANCIS
Last Name:CONIGLIARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LB# 7685 PO BOX 95000
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:8 SHUNPIKE RD STE 2
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-2740
Practice Address - Country:US
Practice Address - Phone:973-845-2045
Practice Address - Fax:973-845-2044
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA062585002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA130025370OtherRR MCR
NJ8237506Medicaid
GA130025370OtherRR MCR
NJ8237506Medicaid