Provider Demographics
NPI:1093259871
Name:MATHEW, SOJAN (RRT)
Entity Type:Individual
Prefix:
First Name:SOJAN
Middle Name:
Last Name:MATHEW
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-5220
Mailing Address - Country:US
Mailing Address - Phone:201-983-3421
Mailing Address - Fax:
Practice Address - Street 1:26 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-5220
Practice Address - Country:US
Practice Address - Phone:201-983-3421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ43ZA005427002278C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedCritical Care