Healthcare Provider Details

I. General information

NPI: 1972868289
Provider Name (Legal Business Name): KAREN MASCOLO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2012
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 LONGVIEW DR
WHIPPANY NJ
07981-2024
US

IV. Provider business mailing address

480 MAIN ST APT 4H
NEW YORK NY
10044-0407
US

V. Phone/Fax

Practice location:
  • Phone: 973-714-3984
  • Fax:
Mailing address:
  • Phone: 973-714-3984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NJ00842700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: