Provider Demographics
NPI:1033240478
Name:ROBERT MASTROIANNI MD INC
Entity Type:Organization
Organization Name:ROBERT MASTROIANNI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATION
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MASTROIANNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-573-8900
Mailing Address - Street 1:81 MAKAWAO AVE.
Mailing Address - Street 2:STE 25
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768
Mailing Address - Country:US
Mailing Address - Phone:808-573-8900
Mailing Address - Fax:808-572-3027
Practice Address - Street 1:81 MAKAWAO AVE STE 25
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-8859
Practice Address - Country:US
Practice Address - Phone:808-573-8900
Practice Address - Fax:808-572-3027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty