Individual
ANJU ANIE MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
475 NORTHERN BLVD STE 19, GREAT NECK, NY 11021-4802
(516) 829-0030
(516) 466-7723
Mailing address
475 NORTHERN BLVD STE 27, GREAT NECK, NY 11021-4802
(516) 829-0030
(516) 466-7723
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
024329
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024329
—
NY
Enumeration date
01/07/2020
Last updated
12/07/2021
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