Individual
VIDYA LYSTRA MATHURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4125 CARPENTER AVENUE, BRONX, NY 10466-1069
(718) 655-0261
(718) 654-7930
Mailing address
1186 KING ST, RYE BROOK, NY 10573-1069
(914) 937-3800
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
018126-1
NY
Other
Enumeration date
10/22/2010
Last updated
09/12/2013
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