Masciocchi, Mark

Masciocchi, Mark is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Neuroradiology. Allopathic & Osteopathic Physicians / Neuroradiology is his primary health care specialty. Masciocchi, Mark can be contacted via phone (508) 334-3850.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655-0002
Phone: (508) 334-3850
Fax: (508) 856-1860
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 257421 Massachusetts
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X 257421 Massachusetts

Profile Details

NPI number 1710204367
LBN Legal business name Masciocchi, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2010
Last updated Jul 26th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710204367 NPPES
Massachusetts MEDICAID 110110489A

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