Individual
MADELINE MATHIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
588 LONGMEADOW ST, LONGMEADOW, MA 01106-2212
(413) 565-1000
Mailing address
375 WILLARD AVE, NEWINGTON, CT 06111-2300
(860) 666-5167
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/05/2022
Last updated
05/22/2024
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