MEDICARE: ANTHONY MASCIARELLI DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	25MB05261500	NJ
2	207RG0100X	Gastroenterology Physician	25MB05261500	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932109717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY MASCIARELLI DO

Provider Business Mailing Address
First Line	:	PO BOX 593
Second Line	:
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-0593
Country	:	US
Telephone Number	:	609-463-2755
Fax Number	:	609-463-2757

Provider Business Practice Location Address
First Line	:	217 N MAIN ST
Second Line	:	SUITE 102
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-2165
Country	:	US
Telephone Number	:	609-536-8010
Fax Number	:	609-536-8053

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	09/22/2014

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