Shortle, Matthew M

Shortle, Matthew M is an individual health care provider with primary practice located at 315 S Manning Blvd @ St Peter'S Hospital Er Dept., Albany NY 12208-1707. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Shortle, Matthew M can be contacted via phone (518) 383-5450.

Contact Information

Primary practice address
315 S Manning Blvd @ St Peter'S Hospital Er Dept. Albany NY 12208-1707
Phone: (518) 383-5450
Fax: (518) 383-4223
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9118121 Florida
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X P65457 New York

Profile Details

NPI number 1235392663
LBN Legal business name Shortle, Matthew M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2008
Last updated Oct 19th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235392663 NPPES
New York Other P65457 TEMP NYS LICENSE

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