Basic Information
| Provider Information | |||||||||
| NPI: | 1477519189 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MATHEW | ||||||||
| FirstName: | SEENA | ||||||||
| MiddleName: | KURIAKOSE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M S OTR L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7333 220TH ST | ||||||||
| Address2: | |||||||||
| City: | OAKLAND GARDENS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113643037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3475380491 | ||||||||
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| Practice Location | |||||||||
| Address1: | 179 TH STREET AND LINDEN BLVD | ||||||||
| Address2: | |||||||||
| City: | ST. ALBANS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185261000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 011925 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.