Individual
MRS. PATRICIA MATHISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27 NORTH STREET, MIDDLETOWN, NY 10940
(845) 342-3900
(845) 343-5390
Mailing address
PO BOX 987, 21 ORCHARD STREET, MIDDLETOWN, NY 10940
(845) 343-7614
(845) 343-5390
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
015117
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355931
—
NY
Enumeration date
06/19/2007
Last updated
07/08/2007
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