Individual
DR. DOMENICO CARMINE MASTANDREA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
45 READE PL, POUGHKEEPSIE, NY 12601-3947
(845) 431-5680
Mailing address
47 OAKBROOK LN, LAGRANGEVILLE, NY 12540-6236
(845) 238-6260
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
264301
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03612993
—
NY
Enumeration date
05/25/2010
Last updated
03/20/2018
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