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General NPI Number Information
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NPI Number | 1386595338
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Entity Type | Individual
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Provider Name | GINA MATHEW
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Gender | Female
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 2200 NORTHERN BLVD
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City | GREENVALE
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State | NY
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Zip | 11548-1219
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Country | US
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Telephone | 516-563-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 812 BELLMORE RD
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City | NORTH BELLMORE
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State | NY
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Zip | 11710-3727
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 354393
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License Number State | NY
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