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Contact Information

MATTHEW RAIDER MD LLC
645 SAYBROOK RD
MIDDLETOWN, CT06457-4746
 Phone: 860-767-4024
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for MATTHEW RAIDER MD LLC

NPI # 1093952194
LBN Legal business name MATTHEW RAIDER MD LLC
Authorized official MATTHEW RAIDER - (SOLE PROPRIETOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/11/2009
Last updated 02/19/2009 - About 17 years ago
Identifiers
CT License # 22948
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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