Provider Demographics
NPI:1447937529
Name:MATHEW, JENEY B (OD)
Entity type:Individual
Prefix:DR
First Name:JENEY
Middle Name:B
Last Name:MATHEW
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 WASHINGTON AVE N
Mailing Address - Street 2:
Mailing Address - City:N WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-1610
Mailing Address - Country:US
Mailing Address - Phone:914-310-6973
Mailing Address - Fax:
Practice Address - Street 1:2781 PALISADES CENTER DR # H206
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-6407
Practice Address - Country:US
Practice Address - Phone:845-358-7186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1224152W00000X
NYTUV009790152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist