Provider Demographics
NPI:1982033882
Name:GUIDONE PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:GUIDONE PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GUIDONE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:315-626-3179
Mailing Address - Street 1:2949 NYS RT 370
Mailing Address - Street 2:
Mailing Address - City:CATO
Mailing Address - State:NY
Mailing Address - Zip Code:13033
Mailing Address - Country:US
Mailing Address - Phone:315-626-3179
Mailing Address - Fax:315-626-5004
Practice Address - Street 1:2949 NYS RT 370
Practice Address - Street 2:
Practice Address - City:CATO
Practice Address - State:NY
Practice Address - Zip Code:13033
Practice Address - Country:US
Practice Address - Phone:315-626-3179
Practice Address - Fax:315-626-5004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-01
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01513112251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCC5095Medicare UPIN