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Mr. Paul Mastrorocco, DISPENSINGOPTICIAN
Optician in Port Jefferson Station, New York
NPI 1801041843

Paul Mastrorocco is a Optician based in Patchogue, NY and is specialized in Optician. Paul Mastrorocco practices in Port Jefferson Station, NY and has the professional credentials of DISPENSINGOPTICIAN. The NPI Number for Paul Mastrorocco is 1801041843 and holds a License No. 5855-1 (New York).

The current practice location address for Paul Mastrorocco is 208 Route 112 Ste 2, Port Jefferson Station, NY and can be reached out via phone at 631-331-0600 and via fax at 631-331-0809.

Location: 208 Route 112 Ste 2, Port Jefferson Station, NY, 11772-3171
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1801041843
Provider Name
Paul Mastrorocco
Credential
DISPENSINGOPTICIAN
Provider Entity Type
Individual
Gender
Male
Address
208 Route 112 Ste 2, Port Jefferson Station, NY, 11772-3171
Phone Number
631-331-0600
Fax Number
631-331-0809
Provider Enumeration Date
11/18/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00342952 05 NY
00683849 05 NY
01934578 05 NY
03292940 05 NY
institution
Provider Business Practice Location Address Details
Address
208 Route 112 Ste 2
City
Port Jefferson Station
State
New York
Zip
11776-1013
Phone Number
631-331-0600
Fax Number
631-331-0809
person
Provider Business Mailing Address Details
Address
208 Route 112 Ste 2
City
Port Jefferson Station
State
New York
Zip
11776-1013
Phone Number
631-331-0600
Fax Number
631-331-0809
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
156FX1800X
License No.
5855-1 (New York)
Definition
Definition to come...
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