Provider Demographics
NPI:1083943419
Name:MATHEW, SUNITA (DPT)
Entity Type:Individual
Prefix:DR
First Name:SUNITA
Middle Name:
Last Name:MATHEW
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1056 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10028
Mailing Address - Country:US
Mailing Address - Phone:212-348-2277
Mailing Address - Fax:212-410-3338
Practice Address - Street 1:1056 5TH AVE
Practice Address - Street 2:
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10028-0031
Practice Address - Country:US
Practice Address - Phone:212-348-2277
Practice Address - Fax:212-410-3338
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028160-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist