Provider Demographics
NPI:1427239763
Name:MASCI, RHONDA KAY (PA)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:KAY
Last Name:MASCI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 BACK ORRVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-9523
Mailing Address - Country:US
Mailing Address - Phone:330-264-4899
Mailing Address - Fax:330-264-4874
Practice Address - Street 1:2525 BACK ORRVILLE RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-9523
Practice Address - Country:US
Practice Address - Phone:330-264-4899
Practice Address - Fax:330-264-4874
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50002640363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9343931Medicare PIN