Healthcare Provider Details

I. General information

NPI: 1225415722
Provider Name (Legal Business Name): JOEL C MATHEWS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2015
Last Update Date: 05/26/2025
Certification Date: 05/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 UNION SQ E
NEW YORK NY
10003-3314
US

IV. Provider business mailing address

24 AVE AT PORT IMPERIAL APT 404
WEST NEW YORK NJ
07093-8410
US

V. Phone/Fax

Practice location:
  • Phone: 212-844-8200
  • Fax:
Mailing address:
  • Phone: 281-748-7585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number300168
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: