Individual
RANJANA MATHUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6146
(631) 548-6150
Mailing address
160 WENTWORTH AVE, ALBERTSON, NY 11507-1727
(516) 248-5245
(516) 248-7195
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
170151
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0132501
GHI
NY
01
—
P00351347
RAILROAD MEDICARE
NY
Enumeration date
09/20/2006
Last updated
04/16/2008
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