Provider Demographics
NPI:1255923728
Name:MASTROCOLA, KARA (PSYD, MED)
Entity type:Individual
Prefix:DR
First Name:KARA
Middle Name:
Last Name:MASTROCOLA
Suffix:
Gender:F
Credentials:PSYD, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 E STREET RD STE 152
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6660
Mailing Address - Country:US
Mailing Address - Phone:215-399-5691
Mailing Address - Fax:
Practice Address - Street 1:825 S 13TH ST APT 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-2670
Practice Address - Country:US
Practice Address - Phone:585-208-8404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-06
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty