Individual
DR. ALBERT JOSEPH MASTRACCIO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
866 MAIN ST, SANFORD, ME 04073-3530
(207) 324-3295
(207) 324-3295
Mailing address
866 MAIN ST, SANFORD, ME 04073-3530
(207) 324-3295
(207) 324-3295
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT652
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037189
ANTHEM
ME
01
—
2162488
AETNA
—
01
—
T31672
HARVARD PILGRIM
—
Enumeration date
11/08/2006
Last updated
07/08/2007
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