Provider Demographics
NPI:1386042224
Name:MATHEW, ALBERT I (RRT)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:
Last Name:MATHEW
Suffix:I
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 1:4259 S SQUIRES LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-1206
Mailing Address - Country:US
Mailing Address - Phone:480-248-9840
Mailing Address - Fax:
Practice Address - Street 1:4259 S SQUIRES LN
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-1206
Practice Address - Country:US
Practice Address - Phone:480-248-9840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ97462279S1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279S1500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredSNF/Subacute Care