Provider Demographics
NPI:1003178419
Name:MCGUIRE, MATTHEW W (MA)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:W
Last Name:MCGUIRE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 OLD FORD CIR
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-2663
Mailing Address - Country:US
Mailing Address - Phone:917-859-9608
Mailing Address - Fax:888-398-8089
Practice Address - Street 1:1221 OLD FORD CIR
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-2663
Practice Address - Country:US
Practice Address - Phone:917-859-9608
Practice Address - Fax:888-398-8089
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1787040174400000X
NY560370051174400000X
NY743030174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist