Individual
MRS. MARY MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
643 SHAMROCK LN, FEASTERVILLE TREVOSE, PA 19053-3527
(267) 600-5407
Mailing address
643 SHAMROCK LN, FEASTERVILLE TREVOSE, PA 19053-3527
(267) 600-5407
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP015558
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
10/20/2015
Last updated
09/22/2020
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