Provider Demographics
NPI:1952031866
Name:MASCARO HEALTH, INC.
Entity Type:Organization
Organization Name:MASCARO HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MASCARO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-448-1348
Mailing Address - Street 1:27 RIVERVIEW TER
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-1155
Mailing Address - Country:US
Mailing Address - Phone:516-448-1348
Mailing Address - Fax:
Practice Address - Street 1:27 RIVERVIEW TER
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1155
Practice Address - Country:US
Practice Address - Phone:516-448-1348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty