Provider Demographics
NPI:1073289153
Name:MATHEW, TRIPTHI M (MPH, MBA, PHD)
Entity Type:Individual
Prefix:DR
First Name:TRIPTHI
Middle Name:M
Last Name:MATHEW
Suffix:
Gender:F
Credentials:MPH, MBA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 GLENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1010
Mailing Address - Country:US
Mailing Address - Phone:973-731-6209
Mailing Address - Fax:
Practice Address - Street 1:31 GLENVIEW DR
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1010
Practice Address - Country:US
Practice Address - Phone:973-731-6209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL049281650183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician