Provider Demographics
NPI:1598739047
Name:GUIDONE, STEPHEN A (PT)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:A
Last Name:GUIDONE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2949 STATE ROUTE 370
Mailing Address - Street 2:
Mailing Address - City:CATO
Mailing Address - State:NY
Mailing Address - Zip Code:13033-9778
Mailing Address - Country:US
Mailing Address - Phone:315-626-3179
Mailing Address - Fax:
Practice Address - Street 1:2949 STATE ROUTE 370
Practice Address - Street 2:
Practice Address - City:CATO
Practice Address - State:NY
Practice Address - Zip Code:13033-9778
Practice Address - Country:US
Practice Address - Phone:315-626-3179
Practice Address - Fax:315-626-5004
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01513112251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1603061Medicaid
NYS83693Medicare UPIN
NYCC5095Medicare ID - Type Unspecified