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General NPI Number Information
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NPI Number | 1396808481
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Entity Type | Individual
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Provider Name | JENNIFER A. MATHUR PH.D.
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Gender | Female
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | FIRST AVENUE AND 27TH STREET ATTENTION 19W33
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone | 212-562-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E 94TH ST APARTMENT 806
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City | NEW YORK
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State | NY
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Zip | 10128-3903
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Country | US
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Telephone | 646-472-9248
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 015789
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 015789
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License Number State | NY
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