Individual
MR. JACOB MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2 CAPITAL WAY STE 456, PENNINGTON, NJ 08534-2521
(609) 537-7300
Mailing address
2 CAPITAL WAY STE 456, PENNINGTON, NJ 08534-2521
(609) 537-7300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00158900
NJ
363A00000X
Physician Assistant
MA051581
PA
363AS0400X
Surgical Physician Assistant
25MP00158900
NJ
Other
Enumeration date
07/19/2007
Last updated
04/26/2021
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