Organization
DEPT OF EDUCATION,NYC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALEYAMMA MATHEW RN (STAFF NURSE)
(718) 556-3603
Entity
Organization
Contact information
Practice address
200 WARDWLELL AVE, STATEN ISLAND, NY 10314
(718) 556-3603
(718) 442-4265
Mailing address
195 HAGAMAN PL, STATEN ISLAND, NY 10302-2035
(718) 556-3603
(718) 720-6851
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
346200-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0398275
—
NY
Enumeration date
03/14/2012
Last updated
03/15/2012
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