Provider Demographics
NPI:1861428880
Name:SPEESLER, MATTHEW JAY (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JAY
Last Name:SPEESLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 6086
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08875-6086
Mailing Address - Country:US
Mailing Address - Phone:732-764-0004
Mailing Address - Fax:732-960-2301
Practice Address - Street 1:1440 HOW LN STE 2F
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-4600
Practice Address - Country:US
Practice Address - Phone:732-764-0004
Practice Address - Fax:732-960-2301
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2022-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA413742080A0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1379704Medicaid
NJC56630Medicare UPIN
NJ517106SQMMedicare PIN