Individual
ANDRES ANTONIO MASCARO PANKOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 LANSDOWNE AVE, DEPT. OF SURGERY, DARBY, PA 19023-1291
(215) 421-3494
Mailing address
330 CEDAR ST FL 3, DEPT. OF PLASTIC SURGERY, NEW HAVEN, CT 06510-3218
(215) 421-3494
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
149967
CA
208600000X
Surgery Physician
149967
CA
208600000X
Surgery Physician
25MA08865700
NJ
208600000X
Surgery Physician
MT189530
PA
Other
Enumeration date
03/29/2011
Last updated
01/10/2018
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