Provider Demographics
NPI:1871766451
Name:MASCELLINO, GLORIA JEAN (RN)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:JEAN
Last Name:MASCELLINO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6714 KELLY ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-1717
Mailing Address - Country:US
Mailing Address - Phone:412-363-7383
Mailing Address - Fax:
Practice Address - Street 1:6714 KELLY ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15208-1717
Practice Address - Country:US
Practice Address - Phone:412-363-7383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN325280L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse