Provider Demographics
NPI:1679822902
Name:MATHEW, ABIN (DPT)
Entity Type:Individual
Prefix:
First Name:ABIN
Middle Name:
Last Name:MATHEW
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 ALMSHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1101
Mailing Address - Country:US
Mailing Address - Phone:267-987-0680
Mailing Address - Fax:
Practice Address - Street 1:944 ALMSHOUSE RD
Practice Address - Street 2:
Practice Address - City:JAMISON
Practice Address - State:PA
Practice Address - Zip Code:18929-1101
Practice Address - Country:US
Practice Address - Phone:267-987-0680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022297225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist