MEDICARE: CHRISTINE MASTRODDI MS, RN, AGACNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	F431026-1	NY

General Provider Information

NPI Number	:	1356896609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE MASTRODDI MS, RN, AGACNP-BC

Provider Business Mailing Address
First Line	:	16 DR TONYS RD
Second Line	:
City	:	KATONAH
State	:	NY
Zip	:	10536-3028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 PELHAM PKWY S
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1138
Country	:	US
Telephone Number	:	718-918-6854
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2016
Last Update Date	:	12/15/2025

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