Provider Demographics
NPI:1790944536
Name:MATHEW, SEENA (MBBS, MD)
Entity Type:Individual
Prefix:DR
First Name:SEENA
Middle Name:
Last Name:MATHEW
Suffix:
Gender:F
Credentials:MBBS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 HIGH ST FL 2A
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-1476
Mailing Address - Country:US
Mailing Address - Phone:609-474-0120
Mailing Address - Fax:
Practice Address - Street 1:137 HIGH ST FL 2A
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-1476
Practice Address - Country:US
Practice Address - Phone:609-474-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08929100207R00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice