Provider Demographics
NPI:1639378151
Name:MASCARINAS, NORMA SANTA IGLESIA
Entity Type:Individual
Prefix:MS
First Name:NORMA
Middle Name:SANTA IGLESIA
Last Name:MASCARINAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 COLUMBIA ST APT 10H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-1916
Mailing Address - Country:US
Mailing Address - Phone:212-353-8492
Mailing Address - Fax:
Practice Address - Street 1:87 COLUMBIA ST APT 10H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-1916
Practice Address - Country:US
Practice Address - Phone:212-353-8492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-14
Last Update Date:2007-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240386163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02158198Medicaid