Basic Information
Provider Information
NPI: 1801174479
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MATHEW
FirstName: SARA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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Mailing Information
Address1: 825 TOWN CENTER DR STE 152
Address2: KIDNEY AND HYPERTENSION ASSOCIATES, P.C.
City: LANGHORNE
State: PA
PostalCode: 190471793
CountryCode: US
TelephoneNumber: 2157413510
FaxNumber: 2157413519
Practice Location
Address1: 825 TOWN CENTER DR
Address2: SUITE 152
City: LANGHORNE
State: PA
PostalCode: 190471753
CountryCode: US
TelephoneNumber: 2157413510
FaxNumber: 2157413519
Other Information
ProviderEnumerationDate: 07/29/2011
LastUpdateDate: 12/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300XMD443610PAY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


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