Healthcare Provider Details

I. General information

NPI: 1558462374
Provider Name (Legal Business Name): MATHEW BIJOY MATHEW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 BOSTON POST RD STE 102
SUDBURY MA
01776-2455
US

IV. Provider business mailing address

111 BOSTON POST RD STE 102
SUDBURY MA
01776-2455
US

V. Phone/Fax

Practice location:
  • Phone: 978-252-0873
  • Fax:
Mailing address:
  • Phone: 978-252-0873
  • Fax: 978-252-0873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number246252
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: