| Shawn Kakkathottathil Mathew, DO | |
|
888 Old Country Rd, Plainview, NY 11803-4914 | |
| (516) 719-3000 | |
| Not Available |
| Full Name | Shawn Kakkathottathil Mathew |
|---|---|
| Gender | Male |
| Speciality | Allergy & Immunology |
| Location | 888 Old Country Rd, Plainview, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528521309 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 318868 (New York) | Secondary |
| 207K00000X | Allergy & Immunology | 318868 (New York) | Primary |
| Entity Name | North Shore-lij Medical Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053688572 PECOS PAC ID: 3375701568 Enrollment ID: O20120220000262 |
| Mailing Address | Practice Location Address |
|---|---|
| Shawn Kakkathottathil Mathew, DO 239 Lafayette St, Williston Park, NY 11596-1515 Ph: (516) 477-9850 | Shawn Kakkathottathil Mathew, DO 888 Old Country Rd, Plainview, NY 11803-4914 Ph: (516) 719-3000 |
Shaan M. Waqar, M.D. Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 146a Manetto Hill Rd Ste 200, Plainview, NY 11803 Phone: 516-931-5353 Fax: 516-931-4235 | |
Dr. Gregory Puglisi, M.D. Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 1171 Old Country Rd, 5, Plainview, NY 11803 Phone: 516-938-7676 Fax: 516-938-7718 | |
Eugene N. Gerardi, MD Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 1171 Old Country Rd, Suite #5, Plainview, NY 11803 Phone: 516-938-7676 Fax: 516-938-7718 | |
Dr. Joseph Anthony Grillo, M.D. Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 1171 Old Country Rd Ste 5, Plainview, NY 11803 Phone: 516-938-7676 |