Healthcare Provider Details

I. General information

NPI: 1649594565
Provider Name (Legal Business Name): JOHN F MASON JR. RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2010
Last Update Date: 03/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 COMMUNITY DR STE 100
GREAT NECK NY
11021-5506
US

IV. Provider business mailing address

4036 168TH ST
FLUSHING NY
11358-2631
US

V. Phone/Fax

Practice location:
  • Phone: 877-662-6633
  • Fax:
Mailing address:
  • Phone: 646-385-6784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number044144
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number28RI03180700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: