Provider Demographics
NPI:1770204828
Name:MASCHER, ALICE
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:MASCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 MARLIN RD
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:CT
Mailing Address - Zip Code:06482-1360
Mailing Address - Country:US
Mailing Address - Phone:813-540-6563
Mailing Address - Fax:
Practice Address - Street 1:75 MARLIN RD
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:CT
Practice Address - Zip Code:06482-1360
Practice Address - Country:US
Practice Address - Phone:813-540-6563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor