MEDICARE: DR. HARVEY G MASOR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	25MA02102900	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538338199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARVEY G MASOR MD

Provider Business Mailing Address
First Line	:	739 CHANCELLOR AVE
Second Line	:
City	:	IRVINGTON
State	:	NJ
Zip	:	07111-2953
Country	:	US
Telephone Number	:	973-371-5959
Fax Number	:	973-371-0171

Provider Business Practice Location Address
First Line	:	739 CHANCELLOR AVE
Second Line	:
City	:	IRVINGTON
State	:	NJ
Zip	:	07111-2953
Country	:	US
Telephone Number	:	973-371-5959
Fax Number	:	973-371-0171

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2008
Last Update Date	:	03/19/2008

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