Healthcare Provider Details

I. General information

NPI: 1285337758
Provider Name (Legal Business Name): KEVIN J MATHEW DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2023
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 E POST RD
WHITE PLAINS NY
10601-4699
US

IV. Provider business mailing address

41 E POST RD
WHITE PLAINS NY
10601-4699
US

V. Phone/Fax

Practice location:
  • Phone: 914-681-0600
  • Fax:
Mailing address:
  • Phone: 914-681-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number342269
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: