Dr. L.R. Masciarelli & Associates Optometry

Primary specialty

OptometristTaxonomy code 152W00000X

License

490 Issued in ND

Legal business name

DR. L.R. MASCIARELLI & ASSOCIATES OPTOMETRY

Practice address

4302 13TH Ave S
Fargo, ND 58103-3395

Phone

(701) 281-9393

NPI assigned

Oct 2, 2007

Last updated

Jun 17, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Leslie Renee Masciarelli, O.D.

Title

Owner/Optometrist

Phone

(701) 281-9393

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1235326398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 13TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033395",
            "telephone_number": "701-281-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 13TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033395",
            "telephone_number": "701-281-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. L.R. MASCIARELLI & ASSOCIATES OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "MASCIARELLI",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "701-281-9393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ND",
            "license": "490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Fargo, ND
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.