Provider Demographics
NPI:1821035734
Name:MASIELLO, CHRISTINE (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:MASIELLO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5930
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-0930
Mailing Address - Country:US
Mailing Address - Phone:302-993-2457
Mailing Address - Fax:302-992-0563
Practice Address - Street 1:4512 KIRKWOOD HWY
Practice Address - Street 2:SUITE 301
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5123
Practice Address - Country:US
Practice Address - Phone:302-993-2457
Practice Address - Fax:302-992-0563
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG0000312363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEP69148Medicare UPIN
DE010431D48Medicare ID - Type Unspecified