Provider Demographics
NPI:1982960589
Name:MATHEW, RAJI (CRNP)
Entity Type:Individual
Prefix:
First Name:RAJI
Middle Name:
Last Name:MATHEW
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 MILLTOWN RD
Mailing Address - Street 2:STE 2
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4047
Mailing Address - Country:US
Mailing Address - Phone:302-352-0517
Mailing Address - Fax:
Practice Address - Street 1:4051 OGLETOWN-STANTON RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-1338
Practice Address - Country:US
Practice Address - Phone:302-943-0426
Practice Address - Fax:877-383-8544
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000658363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily