Provider Demographics
NPI:1912633959
Name:MATHIEU, FRANTZ R (NP)
Entity Type:Individual
Prefix:
First Name:FRANTZ
Middle Name:R
Last Name:MATHIEU
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 HUGHES LN
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-3513
Mailing Address - Country:US
Mailing Address - Phone:516-488-9841
Mailing Address - Fax:
Practice Address - Street 1:28 HUGHES LN
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-3513
Practice Address - Country:US
Practice Address - Phone:516-488-9841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-30
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310810363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health