Mast Clinic, Inc

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

PT677 Issued in ME

Legal business name

MAST CLINIC, INC

Practice address

1 Westbrook CMN
Suite 2
Westbrook, ME 04092-2804

Phone

(207) 892-5328

Fax

(866) 416-3820

NPI assigned

Oct 8, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Jacqueline D Mast, PT MSED

Title

Owner/Manager/Provider

Phone

(207) 892-5328

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286496000000",
    "number": "1134439151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 RACKLEFF ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033054",
            "telephone_number": "207-892-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WESTBROOK CMN",
            "address_2": "SUITE 2",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040922804",
            "telephone_number": "207-892-5328",
            "fax_number": "866-416-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAST CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-08",
        "last_updated": "2010-10-08",
        "status": "A",
        "authorized_official_last_name": "MAST",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/MANAGER/PROVIDER",
        "authorized_official_telephone_number": "207-892-5328",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT MSED"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "ME",
            "license": "PT677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert L Martin II, P.T.
• Ellen Martzial, LCSW
• Mas Medical Staffing Corporation
• Mas Medical Staffing Corporation
• Jenifer E Mascaro, LCPCC, LADC
• Juan C Mateo, PMHNP
• Gabriel E. Matos, MD
• Charles S Matusovich, FNP
• Catriona McInally McCall, RPH
• Alyssa Danielle McCue-McCarthy, FNP-C

• Early Intervention Provider Agency in Westbrook, ME
• Providers in Westbrook, ME by specialty
• Early Intervention Provider Agency in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.