Healthcare Provider Details

I. General information

NPI: 1306010129
Provider Name (Legal Business Name): THOMAS SUNIL MATHEW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 MADISON AVE 4TH FLOOR
NEW YORK NY
10016
US

IV. Provider business mailing address

2 MOUNTAINVIEW TER APT. 5133
DANBURY CT
06810-4163
US

V. Phone/Fax

Practice location:
  • Phone: 212-682-5800
  • Fax: 212-682-5179
Mailing address:
  • Phone: 518-727-7434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number283188
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: