Provider Demographics
NPI:1023136249
Name:PROTOMASTRO, DANA (NP)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:
Last Name:PROTOMASTRO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 LEXINGTON AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3637
Mailing Address - Country:US
Mailing Address - Phone:914-215-1616
Mailing Address - Fax:
Practice Address - Street 1:666 LEXINGTON AVE STE 100
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3637
Practice Address - Country:US
Practice Address - Phone:914-215-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310283363L00000X
NY57511213747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner