Provider Demographics
NPI:1417910324
Name:MASSARO, ARLENE MARGARET (MD)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:MARGARET
Last Name:MASSARO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 NW MAYNARD RD
Mailing Address - Street 2:UNIT 110
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8706
Mailing Address - Country:US
Mailing Address - Phone:919-469-1989
Mailing Address - Fax:919-469-2191
Practice Address - Street 1:1100 NW MAYNARD RD
Practice Address - Street 2:UNIT 110
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8706
Practice Address - Country:US
Practice Address - Phone:919-469-1989
Practice Address - Fax:919-469-2191
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96-00049208000000X, 2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8954585Medicaid