Individual
JACOB ANGELO MASCARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 N 11TH ST, RICHMOND, VA 23219-1901
(804) 828-8643
Mailing address
2015 WATERSIDE RD, PRINCE GEORGE, VA 23875-1265
(804) 287-4216
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101285276
VA
Other
Enumeration date
04/27/2021
Last updated
06/26/2025
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