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General NPI Number Information
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NPI Number | 1255586129
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Entity Type | Individual
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Provider Name | DENNIS GO NG DPT, MBA, MS, CLT
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Gender | Male
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Dates
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Enumeration Date | 11/19/2008
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Last Update Date | 07/11/2018
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Provider Practice Location Address
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Address Line | 500 SENECA ST STE 100
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City | BUFFALO
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State | NY
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Zip | 14204
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Country | US
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Telephone | 716-449-0446
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Fax | 716-408-8863
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Provider Business Mailing Address
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Address Line | 4902 TOWNLINE RD
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City | MEDINA
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State | NY
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Zip | 14103-9744
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Country | US
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Telephone | 585-831-6355
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070010850
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 038890
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 038890
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License Number State | NY
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