Provider Demographics
NPI:1629023510
Name:MASCIO, CHRISTOPHER EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:EDWARD
Last Name:MASCIO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 EAST PENN SQUARE
Mailing Address - Street 2:THE WANAMAKER BLDG 9TH FL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9538
Mailing Address - Fax:267-425-9552
Practice Address - Street 1:34TH & CIVIC CENTER BLVD
Practice Address - Street 2:CHILDREN'S HOSPITAL OF PHILADELPHIA
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4306
Practice Address - Country:US
Practice Address - Phone:215-590-2708
Practice Address - Fax:215-590-2715
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2022-04-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY40431208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100002100Medicaid
IN200849160Medicaid
KY7100002100Medicaid
KYI64197Medicare UPIN