Mastrorocco, Paul

Mastrorocco, Paul is an sole proprietor health care provider with primary practice located at 208 Route 112 Ste 2 , Port Jefferson Station NY 11776-1013. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Mastrorocco, Paul can be contacted via phone (631) 331-0600.

Contact Information

Primary practice address
208 Route 112 Ste 2 Port Jefferson Station NY 11776-1013
Phone: (631) 331-0600
Fax: (631) 331-0809
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X 5855-1 New York

Profile Details

NPI number 1801041843
LBN Legal business name Mastrorocco, Paul
Credentials DISPENSING OPTICIAN
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 18th, 2008
Last updated Sep 17th, 2021 - about 5 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 1801041843 NPPES
New York MEDICAID 00342952
New York MEDICAID 00683849
New York MEDICAID 01934578
New York MEDICAID 03292940

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