Provider Demographics
NPI:1104036169
Name:MASCHAKI, JEANNINE LYNN (ND)
Entity Type:Individual
Prefix:DR
First Name:JEANNINE
Middle Name:LYNN
Last Name:MASCHAKI
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1621
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-0621
Mailing Address - Country:US
Mailing Address - Phone:412-327-3961
Mailing Address - Fax:
Practice Address - Street 1:20455 ROUTE 19
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-7516
Practice Address - Country:US
Practice Address - Phone:412-327-3961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ02-699175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath