Individual
THOMAS EDWARD MASULLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, CRNP-BC
Contact information
Practice address
5901 MARKET ST, PHILADELPHIA, PA 19139-3117
(610) 328-2165
Mailing address
173 FERN AVE, COLLINGSWOOD, NJ 08108-1920
(856) 676-2337
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP024997
PA
Other
Enumeration date
12/06/2021
Last updated
12/06/2021
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