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General NPI Number Information
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NPI Number | 1639998529
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Entity Type | Organization
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Legal Business Name | SEQUOIA MEDICAL 360, P.C.
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 116 KRAFT AVE STE 4
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City | BRONXVILLE
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State | NY
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Zip | 10708-4135
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Country | US
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Telephone | 914-292-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 270 WOODLANDS AVE
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City | WHITE PLAINS
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State | NY
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Zip | 10607-2812
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Country | US
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Telephone | 347-225-6076
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TONY MATHEWS
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Credential | MD, MPH
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Telephone | 347-225-6076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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