Provider Demographics
NPI:1558681098
Name:MASSARI, BERNI (PHD)
Entity Type:Individual
Prefix:DR
First Name:BERNI
Middle Name:
Last Name:MASSARI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 S POWER RD
Mailing Address - Street 2:POWER MEDICAL CENTER SUITE 105
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-5235
Mailing Address - Country:US
Mailing Address - Phone:480-703-0151
Mailing Address - Fax:480-664-1989
Practice Address - Street 1:215 S POWER RD
Practice Address - Street 2:POWER MEDICAL CENTER SUITE 105
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-5235
Practice Address - Country:US
Practice Address - Phone:480-703-0151
Practice Address - Fax:480-664-1989
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZD2220175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath