# PHYSICIAN ASSISTANT ASSOCIATE PLLC

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

## Provider details

- **NPI number:** 1780336917
- **Authorized official:** MR. ROBERT MASCARELLI PA (PHYSICIAN ASSISTANT)
- **Authorized official phone:** (573) 240-6942

## Contact information

- **Practice address:** 1000 MONTAUK HIGHWAY, WEST ISLIP, NY 11795
- **Practice address phone:** (631) 376-3000
- **Mailing address:** 998C OLD COUNTRY RD STE 132, PLAINVIEW, NY 11803-4917
- **Mailing address phone:** (573) 240-6942
- **Mailing address fax:** (516) 827-4517

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |
| 363AS0400X | Surgical Physician Assistant | — | NULL | Yes |
| 363AS0400X | Surgical Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 01/19/2022
- **Last updated:** 01/19/2022