Healthcare Provider Details

I. General information

NPI: 1871651109
Provider Name (Legal Business Name): LINDA J MASON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 03/07/2023
Certification Date: 12/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 ROUTE 300 STE 102
NEWBURGH NY
12550-1738
US

IV. Provider business mailing address

PO BOX 8825
SCARBOROUGH NY
10510-8825
US

V. Phone/Fax

Practice location:
  • Phone: 914-941-0444
  • Fax: 914-941-1199
Mailing address:
  • Phone: 914-941-0444
  • Fax: 914-941-1199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF400772-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: