National Provider Identifier
Theckedath Mathew, M.D.
Theckedath Mathew, M.D. is listed in the NPPES registry with a primary specialty of Cardiovascular Disease Physician in Rochester, NY and a listed phone number of (585) 338-2322.
Profile Overview
- NPI
- 1144264862
- Provider Type
- Individual
- Primary Specialty
- Cardiovascular Disease Physician
- Enumeration Date
- June 15, 2006
- Last Updated
- July 08, 2007
Practice Location
- 1445 Portland Avenue
- Suite 208
- Rochester, NY 14621
Phone: (585) 338-2322
Mailing Address
- 21 Runnymede Court
- Rochester, NE 14618
Specialties
- Cardiovascular Disease Physician (207RC0000X)
Full Record
- NPI
- 1144264862
- Entity Type
- Individual
- Last Name
- Mathew
- First Name
- Theckedath
- Name Prefix
- Dr.
- Credential
- M.D.
- Mailing Street Address
- 21 Runnymede Court
- Mailing City
- Rochester
- Mailing State
- NE
- Mailing ZIP Code
- 14618
- Mailing Country
- US
- Practice Street Address
- 1445 Portland Avenue
- Practice Address Line 2
- Suite 208
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621
- Practice Country
- US
- Practice Phone
- (585) 338-2322
- Enumeration Date
- June 15, 2006
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- X
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Cardiovascular Disease Physician (207RC0000X)
- Other Identifiers
- 00719080 (NY)