Healthcare Provider Details

I. General information

NPI: 1013568351
Provider Name (Legal Business Name): STEVEN P MATHEW PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2019
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 SUNNYSIDE BLVD
PLAINVIEW NY
11803-1539
US

IV. Provider business mailing address

5 HOLIDAY PARK DR
WILLISTON PARK NY
11596-1026
US

V. Phone/Fax

Practice location:
  • Phone: 516-418-8058
  • Fax:
Mailing address:
  • Phone: 516-851-5262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number066063
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: