| Suja Mathew, CRNP | |
|
10203 Clark St, Philadelphia, PA 19116-3814 | |
| (267) 312-2843 | |
| Not Available |
| Full Name | Suja Mathew |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 4 Years |
| Location | 10203 Clark St, Philadelphia, Pennsylvania |
| 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 |
|---|---|---|---|
| 1437743077 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LA2100X | Nurse Practitioner - Acute Care | SP022353 (Pennsylvania) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Trinity Health Mid-atlantic Medical Group | 7416861885 | 333 |
| Entity Name | Trinity Health Mid-atlantic Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093771271 PECOS PAC ID: 7416861885 Enrollment ID: O20040326000613 |
| Entity Name | Nazareth Physician Services, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285150458 PECOS PAC ID: 0941229017 Enrollment ID: O20171026001610 |
| Mailing Address | Practice Location Address |
|---|---|
| Suja Mathew, CRNP 10203 Clark St, Philadelphia, PA 19116-3814 Ph: (267) 312-2843 | Suja Mathew, CRNP 10203 Clark St, Philadelphia, PA 19116-3814 Ph: (267) 312-2843 |
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