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Individual
MATTHEW T GOODEMOTE
Active
Individual
MATTHEW T GOODEMOTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0171611
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02441963
—
NY
01
—
10076606
CDPHP GROUP# K0
NY
01
—
6400651
UNITED HEALTCARE
NY
01
—
710206
MVP
NY
01
—
BSNENY 000922986005
BSNENY EAST STATE ST
NY
01
—
BSNENY 000922986006
BSNENY COMRIE AVE
—
01
—
EMPIRE ST Q09S11
EMPIRE BCBS
NY
Enumeration date
08/01/2006
Last updated
07/15/2015
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