Mastronardi, Theresa Marie

Mastronardi, Theresa Marie is an sole proprietor health care provider with primary practice located at 147 Lake St , Newburgh NY 12550-5263. She recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Mastronardi, Theresa Marie can be contacted via phone (845) 563-8000.

Contact Information

Primary practice address
147 Lake St Newburgh NY 12550-5263
Phone: (845) 563-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 017234-01 New York
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 287403 New York

Profile Details

NPI number 1891082269
LBN Legal business name Mastronardi, Theresa Marie
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 6th, 2011
Last updated Jun 5th, 2019 - about 7 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 1891082269 NPPES
New York MEDICAID 04814595

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