Provider Demographics
NPI:1235308255
Name:MATHEWS, BINIL JOHNSON
Entity Type:Individual
Prefix:MR
First Name:BINIL
Middle Name:JOHNSON
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:BINIL
Other - Middle Name:JOHNSON
Other - Last Name:MATHEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5531 KUAMOO RD
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-9630
Mailing Address - Country:US
Mailing Address - Phone:808-821-2374
Mailing Address - Fax:
Practice Address - Street 1:5531 KUAMOO RD
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-9630
Practice Address - Country:US
Practice Address - Phone:808-821-2374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-24
Last Update Date:2008-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT1384225100000X
NJ40QA00582600225100000X
FLPT11209225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist