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General NPI Number Information
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NPI Number | 1659361004
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Entity Type | Individual
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Provider Name | MARK WILLIAM LAMASTRO MD
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Gender | Male
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 09/26/2014
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Provider Practice Location Address
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Address Line | 728 KING ST.
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City | PORT CHESTER
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State | NY
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Zip | 10573
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Country | US
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Telephone | 914-939-8858
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Fax | 914-939-3814
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Provider Business Mailing Address
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Address Line | 728 KING ST
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City | PORT CHESTER
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State | NY
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Zip | 10573
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Country | US
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Telephone | 914-939-8858
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Fax | 914-939-3814
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 185 362 1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 185 362 1
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License Number State | NY
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