Provider Demographics
NPI:1255845970
Name:MASTRANGELO, DAWN (RN)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:MASTRANGELO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 BALL AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-5042
Mailing Address - Country:US
Mailing Address - Phone:914-433-5186
Mailing Address - Fax:
Practice Address - Street 1:60 BALL AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-5042
Practice Address - Country:US
Practice Address - Phone:914-433-5186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-17
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY564362163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty