| Organization Name: | JOSEPH B MASTERNICK DO INC |
| NPI Number: | 1710130018 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LORETTA BURNICH (OFFICE MANAGER) |
| Mailing Address: | 914 Trailwood Dr Boardman |
| State: | OH US |
| Postal Code: | 445125007 |
| Phone Number: | 3307584568 |
| Fax Number: | 3307585683 |
| NPI Enumeration Date: | 10/30/2008 |
| NPI Last Update Date: | 05/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 34-00-2093 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |