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General NPI Number Information
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NPI Number | 1063233146
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Entity Type | Individual
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Provider Name | MERIN MATHEW
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Gender | Female
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 850 MIX AVE
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City | HAMDEN
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State | CT
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Zip | 06514-2102
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Country | US
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Telephone | 203-281-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 910 FOX CHASE RD APT A3
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City | ROCKLEDGE
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State | PA
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Zip | 19046-4122
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Country | US
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Telephone | 215-936-8032
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 014534
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License Number State | CT
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