1740214949 NPI number — STEPHEN H MASCIO DO

Table of content: (NPI 1740214949)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740214949 NPI number — STEPHEN H MASCIO DO

Organization/Personal Information

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

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:
1740214949
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/17/2011
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:
304-524-1670
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:
304-524-1670
Provider Business Practice Location Address Fax Number:
304-527-1672
Provider Enumeration Date:
07/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MASCIO
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
H
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
304-527-1670

Provider Taxonomy Codes

  • 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" .
  • 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" .

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

  • Identifier: 000000319438 . This is a "ANTHEM BCBS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000117353 . This is a "UNISOM HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000117353 . This is a "THREE RIVERS PROV" identifier , issued by the state of ( OH ) . 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: DC8576 . This is a "RRW MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: G01439A . This is a "MEDICARE PLUS HEALTHPLAN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0242277 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 205314 . This is a "CARELINK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 205314 . This is a "HEALTH AMERICA" identifier . 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: 7716087001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 205314 . This is a "HEALTH ASSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 205314 . This is a "ADVANTRA FREEDOM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 205314 . This is a "CARELINK ADVANTRA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 279582 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3003385000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: G01439A . This is a "HEALTH PLAN MANAGED WORKER'S COMPENSATION PROGRAM" 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: 1060493 . This is a "WORKER'S COMPENSATION" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: G01439A . This is a "THE HEALTH PLAN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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