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General NPI Number Information
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NPI Number | 1336753904
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Entity Type | Individual
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Provider Name | ALEXANDRA JAE MASSARI LAT ATC
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Gender | Female
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Dates
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Enumeration Date | 09/01/2020
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 1307 FEDERAL ST
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City | PITTSBURGH
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State | PA
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Zip | 15212-4769
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Country | US
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Telephone | 412-321-6698
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Fax |
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Provider Business Mailing Address
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Address Line | 122 BRIARWOOD DR
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City | MONONGAHELA
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State | PA
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Zip | 15063-1146
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Country | US
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Telephone | 412-527-4218
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT007748
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License Number State | PA
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