Individual
MICHAEL MASTRANGELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 E BROAD ST, ELYRIA, OH 44035-6306
(440) 365-2600
(440) 366-5543
Mailing address
PO BOX 636643, CINCINNATI, OH 45263-6643
(440) 989-3801
(440) 960-0264
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50004167
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3025372
—
OH
Enumeration date
11/20/2014
Last updated
02/03/2015
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