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1114114295
JISHA MARY MATHEW
BRONX, NY
NPI
1114114295
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 011874)
Enumeration Date
2007-10-02
Last Update Date
2012-05-22
Business Address
-- JISHA MARY MATHEW RPA-C
1065 SOUTHERN BLVD
BRONX, NY 10459-2417
Phone number: 718-589-2440
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Mailing Address
-- JISHA MARY MATHEW RPA-C
1065 SOUTHERN BLVD
BRONX, NY 10459-2417
Phone number: 718-589-2440
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