Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist |
NPI | 1013234046 |
---|---|
Provider Name | Cristina Mastellone |
First Address | Staten Island, NY 10312-4113 |
Second Address | Astoria, NY 11103-3702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2010 |
Last Update Date | 30/04/2010 |