Provider Demographics
NPI:1902298300
Name:MATHEWS, MONISHA (PHARMD)
Entity Type:Individual
Prefix:
First Name:MONISHA
Middle Name:
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ASHBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-4404
Mailing Address - Country:US
Mailing Address - Phone:218-213-7938
Mailing Address - Fax:
Practice Address - Street 1:16 ASHBRIDGE CT
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-4404
Practice Address - Country:US
Practice Address - Phone:218-213-7938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist