Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD008521E | PA |
N | 111NI0900X | Internist | MD008521E | PA |
Y | 207RX0202X | Medical Oncology | MD008521E | PA |
NPI | 1023030368 |
---|---|
Provider Name | Dr. Michael J. Mastrangelo |
First Address | Philadelphia, PA 19107-4216 |
Second Address | Philadelphia, PA 19107-4216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 09/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000596484 | (05) | PA |
7616201 | (05) | NJ |