Individual
MARJORIE MASTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3405 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(302) 236-2978
Mailing address
242 S 8TH ST, APT 4, PHILADELPHIA, PA 19107-5727
(302) 236-2978
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
001201944
VA
163W00000X
Registered Nurse
Primary
0024168887
VA
163WP0200X
Pediatric Registered Nurse
RN655360
PA
Other
Enumeration date
11/20/2013
Last updated
01/13/2014
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