Individual
MR. ANTHONY TIO GOODE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
5815 S PARK AVE, HAMBURG, NY 14075-3738
(716) 648-8700
(716) 648-0400
Mailing address
5815 S PARK AVE, HAMBURG, NY 14075-3738
(716) 648-8700
(716) 648-0400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24366-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027049701
UNIVERA PROV#
NY
01
—
000626886003
BCBS PROV#
NY
01
—
9390493
IHA PROV#
NY
Enumeration date
10/17/2005
Last updated
07/08/2007
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