Healthcare Provider Details

I. General information

NPI: 1598744799
Provider Name (Legal Business Name): KEIRA MASON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE DEPTARTMENT OF ANESTHESIA
BOSTON MA
02115-5724
US

IV. Provider business mailing address

300 LONGWOOD AVE DEPT OF ANESTHESIA
BOSTON MA
02115-5724
US

V. Phone/Fax

Practice location:
  • Phone: 617-789-2782
  • Fax:
Mailing address:
  • Phone: 617-562-5413
  • Fax: 617-562-5415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number82061
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: