Provider Demographics
NPI:1871536417
Name:GRIER, MATTHEW (DO)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:GRIER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GUTHRIE SQ
Mailing Address - Street 2:FAMILY PRACTICE
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840-1625
Mailing Address - Country:US
Mailing Address - Phone:570-882-3517
Mailing Address - Fax:
Practice Address - Street 1:9768 LIBERTY DR
Practice Address - Street 2:
Practice Address - City:PAINTED POST
Practice Address - State:NY
Practice Address - Zip Code:14870-9094
Practice Address - Country:US
Practice Address - Phone:607-937-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1848208100000X
NY241271208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00362291OtherRR MEDICARE PIN
PAP00362291OtherRR MEDICARE PIN
PAGU039851OtherMEDICARE GROUP
PACC9269OtherRR MEDICARE GROUP
NYCC8362OtherRR MEDICARE GROUP
PACC9269OtherRR MEDICARE GROUP
PAGU039851OtherMEDICARE GROUP
PAP00362291OtherRR MEDICARE PIN
PA106633N86Medicare PIN