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General NPI Number Information
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NPI Number | 1891647715
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Entity Type | Organization
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Legal Business Name | MASCARO TELE-MEDICINE P.C.
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 27 RIVERVIEW TER
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City | SMITHTOWN
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State | NY
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Zip | 11787-1155
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Country | US
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Telephone | 516-448-1348
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Fax | 631-265-1168
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Provider Business Mailing Address
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Address Line | 27 RIVERVIEW TER
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City | SMITHTOWN
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State | NY
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Zip | 11787-1155
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Country | US
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Telephone | 516-448-1348
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Fax | 631-265-1168
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Authorized Official
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Title or Position | CEO
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Name | DR. JIMMY R MASCARO
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Credential | DO
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Telephone | 516-448-1348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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