Provider Demographics
NPI:1427188127
Name:MATTHEW R. VOGEL, P.T., P.C.
Entity Type:Organization
Organization Name:MATTHEW R. VOGEL, P.T., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:VOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:631-537-7850
Mailing Address - Street 1:PO BOX 1229
Mailing Address - Street 2:
Mailing Address - City:BRIDGEHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11932-1229
Mailing Address - Country:US
Mailing Address - Phone:631-537-7850
Mailing Address - Fax:631-537-9707
Practice Address - Street 1:128 SAG HARBOR TURNPIKE
Practice Address - Street 2:
Practice Address - City:BRIDGEHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11932
Practice Address - Country:US
Practice Address - Phone:631-537-7850
Practice Address - Fax:631-537-9707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017738225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYY11387Medicare UPIN
NYQ3W7Z1Medicare ID - Type Unspecified