Individual
JERIN JOSE MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
140 OLD ORANGEBURG RD, ORANGEBURG, NY 10962-1157
(845) 680-8600
Mailing address
800A BROOKRIDGE DR APT 82, VALLEY COTTAGE, NY 10989-1891
(845) 689-7261
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
943485
NY
Other
Enumeration date
04/29/2025
Last updated
04/29/2025
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