Provider Demographics
NPI:1447586441
Name:FREAR, MATTHEW W (DPT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:W
Last Name:FREAR
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 1:1 BARNEY RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-5843
Mailing Address - Country:US
Mailing Address - Phone:518-373-0735
Mailing Address - Fax:518-373-7967
Practice Address - Street 1:1 BARNEY RD
Practice Address - Street 2:SUITE 120
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-5843
Practice Address - Country:US
Practice Address - Phone:518-373-0735
Practice Address - Fax:518-373-7967
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY62 032001208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation