Provider Demographics
NPI:1801103577
Name:PLOPINIO, MATIAS ARCHIVALD GO (PT)
Entity type:Individual
Prefix:MR
First Name:MATIAS ARCHIVALD
Middle Name:GO
Last Name:PLOPINIO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:ARCHIE
Other - Middle Name:GO
Other - Last Name:PLOPINIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:4820 39TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-4514
Mailing Address - Country:US
Mailing Address - Phone:917-520-1444
Mailing Address - Fax:718-835-5505
Practice Address - Street 1:8931 161ST ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-6140
Practice Address - Country:US
Practice Address - Phone:917-520-1444
Practice Address - Fax:718-835-5505
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030859225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400074386Medicare PIN
NYG400076907Medicare PIN
NYA400074134Medicare PIN
NYA400073913Medicare PIN