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General NPI Number Information
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NPI Number | 1003419524
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Entity Type | Individual
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Provider Name | MR. MICHAEL FRANCIS MASTROIANNI
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Gender | Male
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 5829 TILGHMAN ST
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City | ALLENTOWN
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State | PA
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Zip | 18104-9129
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Country | US
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Telephone | 610-398-3228
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Fax | 610-530-1815
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Provider Business Mailing Address
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Address Line | 1468 DOVE TER
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City | ALLENTOWN
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State | PA
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Zip | 18106-9712
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Country | US
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Telephone | 908-334-2593
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP032406L
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License Number State | PA
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