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General NPI Number Information
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NPI Number | 1336859610
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Entity Type | Individual
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Provider Name | MR. ERNEST MASSALLA
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Gender | Male
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Dates
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Enumeration Date | 11/28/2022
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 8455 COLESVILLE RD STE 755
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City | SILVER SPRING
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State | MD
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Zip | 20910-3315
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Country | US
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Telephone | 301-298-7793
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Fax | 301-259-3818
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Provider Business Mailing Address
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Address Line | 4005 POSTGATE TER APT 102
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City | SILVER SPRING
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State | MD
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Zip | 20906-6009
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Country | US
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Telephone | 240-277-6216
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP1043299
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R224711
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License Number State | MD
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