Organization
RTM PHYSIATRY AND PSYCHIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THRESIAMMA MATHEW MD (OWNER)
(718) 646-0772
Entity
Organization
Contact information
Practice address
8916 175TH ST STE CF3, JAMAICA, NY 11432-5557
(718) 487-3109
(718) 487-3081
Mailing address
2430 W 3RD ST, BROOKLYN, NY 11223-5930
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
247349
NY
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
04/19/2011
Last updated
03/08/2015
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