Healthcare Provider Details

I. General information

NPI: 1427330141
Provider Name (Legal Business Name): MARYANN E. MASCI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2011
Last Update Date: 10/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 8TH ST
HAMMONTON NJ
08037-3347
US

IV. Provider business mailing address

1030 KINGS HWY N STE 200
CHERRY HILL NJ
08034-1907
US

V. Phone/Fax

Practice location:
  • Phone: 888-985-2727
  • Fax: 609-567-8832
Mailing address:
  • Phone: 888-985-2727
  • Fax: 856-779-0211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00332600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: