Nimmy Mathew, | |
100 E Carroll St, Salisbury, MD 21801-5422 | |
(908) 583-3551 | |
Not Available |
Full Name | Nimmy Mathew |
---|---|
Gender | Female |
Speciality | Hospitalist |
Experience | 8 Years |
Location | 100 E Carroll St, Salisbury, Maryland |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124512843 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208M00000X | Hospitalist | D0091078 (Maryland) | Primary |
390200000X | Student In An Organized Health Care Education/training Program | MT215065 (Pennsylvania) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Peninsula Regional Medical Center | Salisbury, MD | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Tidalhealth Specialty Care Llc | 7113340845 | 192 |
Entity Name | Tidalhealth Specialty Care Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619504735 PECOS PAC ID: 7113340845 Enrollment ID: O20200714000286 |
Mailing Address | Practice Location Address |
---|---|
Nimmy Mathew, 171 E Lincoln Ave, Roselle Park, NJ 07204-1705 Ph: () - | Nimmy Mathew, 100 E Carroll St, Salisbury, MD 21801-5422 Ph: (908) 583-3551 |
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