Provider Demographics
NPI:1487311965
Name:MUSARRO, MARY JO
Entity type:Individual
Prefix:
First Name:MARY JO
Middle Name:
Last Name:MUSARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 W BARLOW RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-2078
Mailing Address - Country:US
Mailing Address - Phone:330-351-2204
Mailing Address - Fax:
Practice Address - Street 1:104 W BARLOW RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-2078
Practice Address - Country:US
Practice Address - Phone:330-351-2204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide