Healthcare Provider Details

I. General information

NPI: 1053093740
Provider Name (Legal Business Name): RUHI MATHEW OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1785 HIGHLAND AVE
CHESHIRE CT
06410-1272
US

IV. Provider business mailing address

PO BOX 25728
NEW YORK NY
10087-7290
US

V. Phone/Fax

Practice location:
  • Phone: 203-271-2020
  • Fax: 203-250-8058
Mailing address:
  • Phone: 703-847-8899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3313
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: