Provider Demographics
NPI:1861727083
Name:GERDES, MATTHEW FRANCIS (DPT)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:FRANCIS
Last Name:GERDES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 LANDMARK PL
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1025
Mailing Address - Country:US
Mailing Address - Phone:732-800-1078
Mailing Address - Fax:732-912-7212
Practice Address - Street 1:2260 LANDMARK PL
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1025
Practice Address - Country:US
Practice Address - Phone:732-800-1078
Practice Address - Fax:732-912-7212
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00972800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist