Provider Demographics
NPI:1639465164
Name:MASTRINE, ASHLEY MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:MARIE
Last Name:MASTRINE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:CRESSON
Mailing Address - State:PA
Mailing Address - Zip Code:16630-1114
Mailing Address - Country:US
Mailing Address - Phone:814-886-8393
Mailing Address - Fax:814-886-6871
Practice Address - Street 1:701 FRONT ST
Practice Address - Street 2:
Practice Address - City:CRESSON
Practice Address - State:PA
Practice Address - Zip Code:16630-1114
Practice Address - Country:US
Practice Address - Phone:814-886-8393
Practice Address - Fax:814-886-6871
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002463152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist