Healthcare Provider Details

I. General information

NPI: 1780325514
Provider Name (Legal Business Name): MASON WEBB DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 LIBERTY ST
NEW HAVEN CT
06519-1625
US

IV. Provider business mailing address

184 LIBERTY ST
NEW HAVEN CT
06519-1625
US

V. Phone/Fax

Practice location:
  • Phone: 480-532-4426
  • Fax:
Mailing address:
  • Phone: 480-532-4423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1.084392-DO
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: