Provider Demographics
NPI:1174390736
Name:JUNIO, MATTHEW MICHAEL (MS, LAT ATC)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:MICHAEL
Last Name:JUNIO
Suffix:
Gender:M
Credentials:MS, LAT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MADALINE DR
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1127
Mailing Address - Country:US
Mailing Address - Phone:908-769-8326
Mailing Address - Fax:
Practice Address - Street 1:218 MOUNTAIN WAY
Practice Address - Street 2:
Practice Address - City:LYNDURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-1614
Practice Address - Country:US
Practice Address - Phone:551-587-8010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0074272255A2300X
NJ25MT002663002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer