Provider Demographics
NPI:1508201559
Name:MATHEWS, TONY (MD)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 N BROADWAY STE C
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-2222
Mailing Address - Country:US
Mailing Address - Phone:914-428-6000
Mailing Address - Fax:914-948-8624
Practice Address - Street 1:15 N BROADWAY STE C
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-2222
Practice Address - Country:US
Practice Address - Phone:914-428-6000
Practice Address - Fax:914-948-8624
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY283602207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program