Provider Demographics
NPI:1891685699
Name:MASTINO, JASON ANTHONY
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:ANTHONY
Last Name:MASTINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5810 US HIGHWAY 20 LOT 152
Mailing Address - Street 2:
Mailing Address - City:WAKEMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44889-8986
Mailing Address - Country:US
Mailing Address - Phone:419-706-0353
Mailing Address - Fax:
Practice Address - Street 1:5810 US HIGHWAY 20 LOT 152
Practice Address - Street 2:
Practice Address - City:WAKEMAN
Practice Address - State:OH
Practice Address - Zip Code:44889-8986
Practice Address - Country:US
Practice Address - Phone:419-706-0353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-03
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant