Provider Demographics
NPI:1063508760
Name:MASTRIANO, CHRISTOPHER FRANCIS (MS, SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:FRANCIS
Last Name:MASTRIANO
Suffix:
Gender:M
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1950 COMMONWEALTH AVE
Mailing Address - Street 2:APT 26
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-5804
Mailing Address - Country:US
Mailing Address - Phone:508-274-5685
Mailing Address - Fax:857-203-5507
Practice Address - Street 1:1400 VFW PKWY
Practice Address - Street 2:126
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-4927
Practice Address - Country:US
Practice Address - Phone:857-203-6771
Practice Address - Fax:857-203-5507
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA6991235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist