Individual
JASON MICHEAL MASHTARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2989 N MAIN ST, PERU, NY 12972, PLATTSBURGH, NY 12901
(518) 643-2740
Mailing address
1 HILLTOP WAY COLLINS, PLATTSBURGH, NY 12901
(518) 570-5821
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010642
NY
Other
Enumeration date
07/09/2021
Last updated
07/09/2021
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