Healthcare Provider Details
I. General information
NPI: 1346531159
Provider Name (Legal Business Name): MS. BRITTANY ANN MASSARE
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/27/2011
Last Update Date: 07/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 UNIVERSITY DR
HERSHEY PA
17033-2360
US
IV. Provider business mailing address
500 UNIVERSITY DR UNIVERSITY HOSPITALS CASE MEDICAL CENTER
HERSHEY PA
17033-2360
US
V. Phone/Fax
- Phone: 800-243-1455
- Fax:
- Phone: 800-243-1455
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MD450855 |
| License Number State | PA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: