Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mariamma Mathew Idichandy

Individual provider Medical-Surgical Registered Nurse · NPI 1659093698

Mariamma Mathew Idichandy is a Medical-Surgical Registered Nurse in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2022.

Licensed in
PA
In the registry since
2022

Practice location Address checks out

5501 Old York Rd Ste 1
Philadelphia, PA 19141-3098
Phone: (215) 456-7890
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical-Surgical Registered Nurse (primary) Taxonomy 163WM0705X · Licence 210460994 (PA)

Record details

NPI number1659093698
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 15, 2022
Last updated in NPPESSeptember 15, 2022
Certification dateSeptember 15, 2022
Mailing address7707 Bradford St, Philadelphia, PA 19152-3809

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