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General NPI Number Information
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NPI Number | 1871137646
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Entity Type | Individual
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Provider Name | JINU MATHEW THOMAS
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Gender | Female
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Dates
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Enumeration Date | 11/04/2019
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 4045 HEMPSTEAD TPKE FL 3
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City | BETHPAGE
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State | NY
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Zip | 11714-5611
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Country | US
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Telephone | 516-731-7770
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Fax |
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Provider Business Mailing Address
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Address Line | 263 BRYANT AVE
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City | FLORAL PARK
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State | NY
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Zip | 11001-1223
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Country | US
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Telephone | 914-471-6581
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 431553
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License Number State | NY
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