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General NPI Number Information
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NPI Number | 1275643322
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Entity Type | Individual
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Provider Name | DANIEL J MASTELLA MD
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 622 HEBRON AVE STE 205
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City | GLASTONBURY
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State | CT
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Zip | 06033-2421
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Country | US
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Telephone | 860-527-7161
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Fax | 860-652-8410
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Provider Business Mailing Address
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Address Line | 622 HEBRON AVE STE 205
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City | GLASTONBURY
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State | CT
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Zip | 06033-2421
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Country | US
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Telephone | 860-527-7161
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Fax | 860-652-8410
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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 | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | MD419529
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 041663
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 41663
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License Number State | CT
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