Provider Demographics
NPI:1093504136
Name:MATHEWS, JULIANA
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:MATHEWS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6236 59TH DR
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-3455
Mailing Address - Country:US
Mailing Address - Phone:518-752-1282
Mailing Address - Fax:
Practice Address - Street 1:6236 59TH DR
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-3455
Practice Address - Country:US
Practice Address - Phone:518-752-1282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator