Healthcare Provider Details

I. General information

NPI: 1427239763
Provider Name (Legal Business Name): RHONDA KAY MASCI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 BACK ORRVILLE RD
WOOSTER OH
44691-9523
US

IV. Provider business mailing address

2525 BACK ORRVILLE RD
WOOSTER OH
44691-9523
US

V. Phone/Fax

Practice location:
  • Phone: 330-264-4899
  • Fax: 330-264-4874
Mailing address:
  • Phone: 330-264-4899
  • Fax: 330-264-4874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50002640
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: