Provider Demographics
NPI:1851501282
Name:MASECAMPO, ALFE A (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFE
Middle Name:A
Last Name:MASECAMPO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:900 DUDLEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-4426
Mailing Address - Country:US
Mailing Address - Phone:856-541-1700
Mailing Address - Fax:856-346-3627
Practice Address - Street 1:1 COLBY AVE STE 7
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1000
Practice Address - Country:US
Practice Address - Phone:856-541-1700
Practice Address - Fax:856-346-3627
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA352432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3937305Medicaid
NJAM8523993OtherDEA
NJ716608Medicare UPIN
NJAM8523993OtherDEA