Healthcare Provider Details

I. General information

NPI: 1841951001
Provider Name (Legal Business Name): MATTHEW HUDSON MCGRATH PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2022
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ATWELL RD
COOPERSTOWN NY
13326
US

IV. Provider business mailing address

1 ATWELL RD
COOPERSTOWN NY
13326-1301
US

V. Phone/Fax

Practice location:
  • Phone: 607-547-3456
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110008693
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number035842
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: