Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 140408-1 | NY |
Y | 213ES0000X | Sports Medicine | 140408-1 | NY |
NPI | 1477691855 |
---|---|
Provider Name | Dr. Daniel Mathews |
First Address | Bronxville, NY 10708-3403 |
Second Address | Bronxville, NY 10708-3403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 08/07/2007 |