NPI 1093086688

Derrick Mathis

Practitioner Community Health Worker Philadelphia, PA

Practice location

Address: 1551 N 29th St Suite 1, Philadelphia, PA 19121-3620
Phone: (267) 988-5613
Mailing address: 3202 Hamilton St Suite 1, Philadelphia, PA 19104-2517

Registered specialties (6)

Community Health Worker Primary

Other Service Providers Taxonomy 172V00000X

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Driver

Other Service Providers Taxonomy 172A00000X

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Chore Provider

Nursing Service Related Providers Taxonomy 372500000X

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Adult Companion

Nursing Service Related Providers Taxonomy 372600000X

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Home Health Aide

Nursing Service Related Providers Taxonomy 374U00000X

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Nurse's Aide

Nursing Service Related Providers Taxonomy 376K00000X

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Registry record

NPI: 1093086688
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Jan 2012
Record last updated: 13 Jan 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.