Provider Demographics
NPI:1871179580
Name:MATHIEU, JOANNE (DNP, AGPCNP-BC)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:
Last Name:MATHIEU
Suffix:
Gender:
Credentials:DNP, AGPCNP-BC
Other - Prefix:MRS
Other - First Name:JOANNE
Other - Middle Name:MATHIEU
Other - Last Name:ELIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7009 261ST ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:GLEN OAKS
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1013
Mailing Address - Country:US
Mailing Address - Phone:718-309-4019
Mailing Address - Fax:
Practice Address - Street 1:1275 YORK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6007
Practice Address - Country:US
Practice Address - Phone:646-992-5816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309483363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health