Healthcare Provider Details

I. General information

NPI: 1861991713
Provider Name (Legal Business Name): MATHEWS HOME CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2018
Last Update Date: 02/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 KISCO AVE STE 403
MOUNT KISCO NY
10549-1409
US

IV. Provider business mailing address

185 KISCO AVE STE 403
MOUNT KISCO NY
10549-1409
US

V. Phone/Fax

Practice location:
  • Phone: 914-606-1038
  • Fax: 914-864-0589
Mailing address:
  • Phone: 914-606-1038
  • Fax: 914-864-0589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2497L
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. REGI MATHEWS
Title or Position: CEO/OWNER
Credential:
Phone: 914-864-0588