Healthcare Provider Details

I. General information

NPI: 1790245470
Provider Name (Legal Business Name): SHERYL MATHEW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WHITE HORSE RD STE 904
VOORHEES NJ
08043-4415
US

IV. Provider business mailing address

660 WHITE PLAINS RD STE 400
TARRYTOWN NY
10591-5107
US

V. Phone/Fax

Practice location:
  • Phone: 856-576-5747
  • Fax: 856-519-5265
Mailing address:
  • Phone: 914-984-2546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD485341
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number25MA12259300
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number25MA12259300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: