Healthcare Provider Details

I. General information

NPI: 1841369725
Provider Name (Legal Business Name): BRIAN JAMES MASON PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W MAIN ST
FREEHOLD NJ
07728-2537
US

IV. Provider business mailing address

48 POLO CLUB DR
FREEHOLD NJ
07728-8069
US

V. Phone/Fax

Practice location:
  • Phone: 732-294-2700
  • Fax: 732-294-2568
Mailing address:
  • Phone: 732-780-5221
  • Fax: 732-294-2568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberQA00403300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: