Provider Demographics
NPI:1497192330
Name:MASYGA, MARCY ANN (DO)
Entity type:Individual
Prefix:
First Name:MARCY
Middle Name:ANN
Last Name:MASYGA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MARCY
Other - Middle Name:ANN
Other - Last Name:GARGIULO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:908 NIAGARA FALLS BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2019
Mailing Address - Country:US
Mailing Address - Phone:716-692-2160
Mailing Address - Fax:716-213-0348
Practice Address - Street 1:230 S CASCADE DRIVE
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:14141-9705
Practice Address - Country:US
Practice Address - Phone:716-592-3600
Practice Address - Fax:716-592-3613
Is Sole Proprietor?:No
Enumeration Date:2013-06-02
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY284673207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine