Healthcare Provider Details
I. General information
NPI: 1689510539
Provider Name (Legal Business Name): ANN MATHEW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1278 FULTON AVENUE, 10456 BRONX CARE HEALTH SYSTEMS, DEPARTMENT OF PSYCHIATRY GME OFFICE
BRONX NY
10456
US
IV. Provider business mailing address
1278 FULTON AVENUE, 10456 BRONX CARE HEALTH SYSTEMS, DEPARTMENT OF PSYCHIATRY GME OFFICE
BRONX NY
10456
US
V. Phone/Fax
- Phone: 718-901-8653
- Fax:
- Phone: 718-901-8653
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: