Provider Demographics
NPI:1588004717
Name:MASTRIANNI, MARY ELIZABETH (FNP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELIZABETH
Last Name:MASTRIANNI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:1201 NOTT ST STE 204
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-2589
Mailing Address - Country:US
Mailing Address - Phone:518-243-3388
Mailing Address - Fax:518-243-1329
Practice Address - Street 1:1201 NOTT ST STE 204
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2589
Practice Address - Country:US
Practice Address - Phone:518-243-3388
Practice Address - Fax:518-243-1329
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY337972363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily