Provider Demographics
NPI:1639192784
Name:TOMAINO, MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:TOMAINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 S CLINTON AVE STE 405
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5719
Mailing Address - Country:US
Mailing Address - Phone:585-565-3500
Mailing Address - Fax:585-434-4081
Practice Address - Street 1:1815 S CLINTON AVE STE 405
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5719
Practice Address - Country:US
Practice Address - Phone:585-565-3500
Practice Address - Fax:585-434-4081
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171436207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYIA1398Medicare PIN
F28418Medicare UPIN