Basic Information
| Provider Information | |||||||||
| NPI: | 1194047233 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MATHEW | ||||||||
| FirstName: | SHERIN | ||||||||
| MiddleName: | ALEX | ||||||||
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| Credential: | D.PHARM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1070 HARROW RD | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN SQUARE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110101709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5168846592 | ||||||||
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| Practice Location | |||||||||
| Address1: | 27111 76TH AVE | ||||||||
| Address2: | |||||||||
| City: | NEW HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110401436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182892100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2010 | ||||||||
| LastUpdateDate: | 02/16/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 051121 | NY | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.