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NPI Code Detail

MEDICARE: MICHELE MATHEW PHARMD

MEDICARE: MICHELE MATHEW PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist073534NY

General Provider Information

NPI Number : 1760347892
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE MATHEW PHARMD
Provider Business Mailing Address
First Line : 288 MARTIN AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-4328
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 475 SEAVIEW AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10305-3436
Country : US
Telephone Number : 347-553-4233
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2025
Last Update Date : 12/20/2025

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Directions to “ MICHELE MATHEW PHARMD” Practice Location

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