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General NPI Number Information
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NPI Number | 1750170601
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Entity Type | Individual
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Provider Name | MRS. ANITHA MATHEW MEENAMGATTU
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Gender | Female
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 7925 WINCHESTER BLVD
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City | QUEENS VILLAGE
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State | NY
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Zip | 11427-2128
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Country | US
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Telephone | 718-464-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 74 LANDAU AVE
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City | ELMONT
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State | NY
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Zip | 11003-1918
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Country | US
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Telephone | 516-270-7381
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 613377
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License Number State | NY
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