Provider Demographics
NPI:1326584863
Name:DR MASCARENHAS CARDIOLOGY
Entity Type:Organization
Organization Name:DR MASCARENHAS CARDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELL
Authorized Official - Middle Name:A N
Authorized Official - Last Name:MASCARENHAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-253-4898
Mailing Address - Street 1:175 S 21ST ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3835
Mailing Address - Country:US
Mailing Address - Phone:610-253-4898
Mailing Address - Fax:610-253-6355
Practice Address - Street 1:175 S 21ST STREET
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042
Practice Address - Country:US
Practice Address - Phone:610-253-4898
Practice Address - Fax:610-253-6355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051153L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF68826Medicare UPIN
NJ419397N5QMedicare PIN
PAF68826Medicare UPIN
PA419373N6LMedicare PIN