Provider Demographics
NPI:1669351417
Name:MASTANDREA, ANGELA (CPS)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MASTANDREA
Suffix:
Gender:F
Credentials:CPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1277 BROADWAY APT 3
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-1799
Mailing Address - Country:US
Mailing Address - Phone:617-694-7290
Mailing Address - Fax:
Practice Address - Street 1:77 SALEM ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5228
Practice Address - Country:US
Practice Address - Phone:617-581-8355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist