# JUDITH M. MASCOLO, MD, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043406812
- **Authorized official:** DR. JUDITH M MASCOLO M.D. (OWNER)
- **Authorized official phone:** (860) 233-4600

## Contact information

- **Practice address:** 639 PARK RD, STE 100, WEST HARTFORD, CT 06107-3443
- **Practice address phone:** (860) 233-4600
- **Practice address fax:** (860) 233-4604
- **Mailing address:** 639 PARK RD STE 100, WEST HARTFORD, CT 06107-3443
- **Mailing address phone:** (860) 233-4600
- **Mailing address fax:** (860) 233-4604

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 036592 | CT | Yes |

## Other

- **Enumeration date:** 09/14/2007
- **Last updated:** 04/28/2014