Healthcare Provider Details

I. General information

NPI: 1063091866
Provider Name (Legal Business Name): NATALIE MASI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 04/07/2021
Certification Date: 04/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S 8TH ST STE 2I
PHILADELPHIA PA
19106-4017
US

IV. Provider business mailing address

737 JAEGER ST
COLUMBUS OH
43206-2274
US

V. Phone/Fax

Practice location:
  • Phone: 267-322-7700
  • Fax:
Mailing address:
  • Phone: 862-266-6988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN659990
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: