Individual provider · Type 1 NPI
Mariamma Mathew Idichandy
Medical-Surgical Registered Nurse · Philadelphia, PA
NPI number
1659093698
Active
Practice location
5501 Old York Rd Ste 1
Philadelphia, PA 19141-3098
Mailing address
7707 Bradford St
Philadelphia, PA 19152-3809
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical-Surgical Registered Nurse Primary | 163WM0705X | 210460994 (PA) |
Medical-Surgical Registered Nurse: Definition to come...
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About NPI 1659093698
Mariamma Mathew Idichandy's National Provider Identifier is 1659093698, issued on Sep 15, 2022. The primary taxonomy on file is Medical-Surgical Registered Nurse (163WM0705X), and the practice location is in Philadelphia, PA. The record was last updated on Sep 15, 2022.