1942524830 NPI number — DR. MICHAEL JEFFREY MASON PH.D.

Table of content: DR. MICHAEL JEFFREY MASON PH.D. (NPI 1942524830)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942524830 NPI number — DR. MICHAEL JEFFREY MASON PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MASON
Provider First Name:
MICHAEL
Provider Middle Name:
JEFFREY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942524830
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
582 SCARBOROUGH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRIARCLIFF MANOR
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10510-2020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-645-0723
Provider Business Mailing Address Fax Number:
914-941-1199

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1607 ROUTE 300
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
NEWBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12550-1738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-645-0723
Provider Business Practice Location Address Fax Number:
914-941-1199
Provider Enumeration Date:
03/21/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  001422 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com