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General NPI Number Information
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NPI Number | 1285088948
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Entity Type | Individual
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Provider Name | DR. KEVIN MATHEW
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Gender | Male
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Dates
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Enumeration Date | 04/19/2016
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Last Update Date | 02/14/2020
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Provider Practice Location Address
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Address Line | 706 W MAIN ST
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City | NEW HOLLAND
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State | PA
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Zip | 17557-9328
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Country | US
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Telephone | 717-354-4268
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Fax |
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Provider Business Mailing Address
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Address Line | 706 W MAIN ST
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City | NEW HOLLAND
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State | PA
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Zip | 17557-9328
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP453848
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 061094
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License Number State | NY
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