Provider Demographics
NPI:1649244815
Name:MASTRANTONIO, JOHN J (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:MASTRANTONIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1915-25 CENTRAL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710
Mailing Address - Country:US
Mailing Address - Phone:914-961-0201
Mailing Address - Fax:914-961-6365
Practice Address - Street 1:1915-25 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710
Practice Address - Country:US
Practice Address - Phone:914-961-0201
Practice Address - Fax:914-961-6365
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY101929207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY13269499404Other1199 - BRONX
NY0530998OtherAETNA/USHC
NY13269499407Other1199 - YONKERS
NY4359AOtherMAGNACARE - YONKERS
NYEMPIRE HEALTHCHOICEOtherJM09660310
NY0075076OtherGHI
NY101929OtherHIP
NY4359BOtherMAGNACARE - BRONX
NYC77946OtherAMERIAHEALTH ADMINISTRATORS
NY003480OtherCONNECTICARE
NY101929-B14OtherHEALTHFIRST
NY080731000082OtherFIDELIS
101929-A14OtherHEALTHFIRST
NY21147OtherMONTEFIORE CMO
160030905OtherMEDICARE RAILROAD
NY4096891OtherAETNA
NY0530998OtherAETNA/USHC