Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 309674-01 | NY |
NPI | 1033564596 |
---|---|
Provider Name | Dr. Merlyn Mathew |
First Address | Brooklyn, NY 11235-7745 |
Second Address | Lawrence, NY 11559-8507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2016 |
Last Update Date | 07/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
FR97383U | (05) | NY |