Provider Demographics
NPI:1952833162
Name:MATHEW, JEFFY (MD)
Entity Type:Individual
Prefix:
First Name:JEFFY
Middle Name:
Last Name:MATHEW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WOODS ROAD
Mailing Address - Street 2:DEPT OF PULMONARY AND CRITICAL CARE MACY - ROOM 1042
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595
Mailing Address - Country:US
Mailing Address - Phone:914-493-7518
Mailing Address - Fax:914-493-8130
Practice Address - Street 1:100 WOODS ROAD
Practice Address - Street 2:DEPT OF PULMONARY AND CRITICAL CARE MACY - ROOM 1042
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-493-7518
Practice Address - Fax:914-493-8130
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY304495207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine