MEDICARE: SONIA MATHEW

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
1	363LF0000X	Family Nurse Practitioner	306388	AZ

General Provider Information

NPI Number	:	1801602263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONIA MATHEW

Provider Business Mailing Address
First Line	:	22424 S ELLSWORTH LOOP RD ,#784
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9494 W NORTHERN AVE STE 101
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85305-1119
Country	:	US
Telephone Number	:	689-305-6528
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2024
Last Update Date	:	05/06/2026

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Directions to “ SONIA MATHEW ” Practice Location

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