1790786853 NPI number — STEPHEN H MASCIO D.O.

Table of content: STEPHEN H MASCIO D.O. (NPI 1790786853)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790786853 NPI number — STEPHEN H MASCIO D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MASCIO
Provider First Name:
STEPHEN
Provider Middle Name:
H
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790786853
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/31/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1417 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FOLLANSBEE
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26037-1217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-527-1670
Provider Business Mailing Address Fax Number:
304-527-1672

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1417 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FOLLANSBEE
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26037-1217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-527-1670
Provider Business Practice Location Address Fax Number:
304-527-1672
Provider Enumeration Date:
08/10/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  1439 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: 34006186 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000667A . This is a "UPMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 66588 . This is a "CARELINK HEALTH PLANS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: WV9999 . This is a "MUTUAL OF OMAHA COMPANIES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000319438 . This is a "ANTHEM BCBS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 001464699 . This is a "HIGHMARK BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001705867 . This is a "MSBCBS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 020643708 . This is a "WORKER'S COMPENSATION" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 02064370800 . This is a "1-888-OHIO COMP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 02064370800 . This is a "MANAGED MEDICAL ASSURANCE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 02064370800 . This is a "COMPMANAGEMENT HEALTH SYSTEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 104698 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1060493 . This is a "SEDGWICK CLAIMS MANAGEMENT SERVICES, INC." identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 020643708 A01 . This is a "MEDICAL MUTUAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 020643708001 . This is a "MEDICAL MUTUAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 205314 . This is a "CARELINK HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 279582 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000117353 . This is a "UNISON HEALTH PLAN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 02064370800 . This is a "WORKER'S COMPENSATION" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 02064370800 . This is a "COMPMANAGEMENT" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0206437080001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".