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General NPI Number Information
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NPI Number | 1104560523
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Entity Type | Individual
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Provider Name | SARAH MASTROROCCO OD
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Gender | Female
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Dates
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Enumeration Date | 04/21/2022
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 201 EDDIE CHASTEEN DR
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City | WALTERBORO
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State | SC
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Zip | 29488-5728
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Country | US
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Telephone | 843-699-8145
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Fax | 843-549-0104
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Provider Business Mailing Address
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Address Line | 1150 WINDSOR DR
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City | MINERAL WELLS
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State | WV
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Zip | 26150-6779
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Country | US
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Telephone | 304-615-3764
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.007041
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License Number State | OH
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