MR. PAUL MASTROROCCO DISPENSING OPTICIAN NPI 1801041843

NPI Information

NPI: 1801041843
Provider Name: MR. PAUL MASTROROCCO, DISPENSING OPTICIAN
Classification: Technician/Technologist - 156FX1800X
Entity Type: Individual

Specialization: Optician

Address:
208 ROUTE 112 STE 2
PORT JEFFERSON STATION, NY
ZIP 11776
Phone: (631) 331-0600
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MR. Paul Mastrorocco, DISPENSING OPTICIAN is an optician technician technologist in Port Jefferson Station, NY. MR. Paul Mastrorocco, DISPENSING OPTICIAN NPI is 1801041843. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

208 ROUTE 112 STE 2
PORT JEFFERSON STATION, NY
ZIP 11776-013
Phone: (631) 331-0600
Fax: (631) 331-0809

The enumeration date for this NPI number is 11/18/2008 and was last updated on 9/17/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	156FX1800X	Technician/Technologist	Optician	5855-1	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	00683849	MEDICAID	NEW YORK
2	00342952	MEDICAID	NEW YORK
3	03292940	MEDICAID	NEW YORK
4	01934578	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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