Provider Demographics
NPI:1922413582
Name:MASCIA, STEPHANIE JOHANNA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:JOHANNA
Last Name:MASCIA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:JOHANNA
Other - Last Name:ANTOINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 MOUNT AUBURN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-4518
Mailing Address - Country:US
Mailing Address - Phone:617-491-5586
Mailing Address - Fax:617-349-3923
Practice Address - Street 1:625 MOUNT AUBURN ST STE 104
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4518
Practice Address - Country:US
Practice Address - Phone:617-491-5586
Practice Address - Fax:617-661-5995
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine