MEDICARE: DR. MATTHEW TOMAINO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	171436	NY
2	207XS0106X	Orthopaedic Hand Surgery Physician	171436	NY

General Provider Information

NPI Number	:	1639192784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW TOMAINO M.D.

Provider Business Mailing Address
First Line	:	1815 S CLINTON AVE STE 405
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-5719
Country	:	US
Telephone Number	:	585-565-3500
Fax Number	:	585-434-4081

Provider Business Practice Location Address
First Line	:	1815 S CLINTON AVE STE 405
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-5719
Country	:	US
Telephone Number	:	585-565-3500
Fax Number	:	585-434-4081

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	02/02/2021

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