Individual
MRS. ANNAMMA MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
59 TIMBER RIDGE DRIVE, COMMACK, NY 11725
(631) 269-0892
(631) 269-0892
Mailing address
59 TIMBER RIDGE DRIVE, COMMACK, NY 11725
(631) 269-0892
(631) 269-0892
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
303568
NY
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
303568
NY
Other
Enumeration date
09/18/2008
Last updated
09/18/2008
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