Individual
MR. RENJU MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
844 HEMLOCK ST, FRANKLIN SQ, NY 11010-4008
(516) 270-5813
Mailing address
844 HEMLOCK ST, FRANKLIN SQ, NY 11010-4008
(516) 270-5813
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
406361
NY
Other
Enumeration date
12/14/2024
Last updated
05/14/2026
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