Provider Demographics
NPI:1083928667
Name:MASTRINE, NICK REGIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NICK
Middle Name:REGIS
Last Name:MASTRINE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 STALLION CIR
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-1119
Mailing Address - Country:US
Mailing Address - Phone:814-248-8079
Mailing Address - Fax:
Practice Address - Street 1:2500 BOULEVARD OF THE GENERALS
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-3692
Practice Address - Country:US
Practice Address - Phone:610-539-5093
Practice Address - Fax:610-539-5294
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443954183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist