Healthcare Provider Details

I. General information

NPI: 1528017977
Provider Name (Legal Business Name): VERONICA V MASON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 03/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 SAWYER DR STE 6
NIAGARA FALLS NY
14304-2979
US

IV. Provider business mailing address

2131 SAWYER DR STE 6
NIAGARA FALLS NY
14304-2979
US

V. Phone/Fax

Practice location:
  • Phone: 716-216-4424
  • Fax: 716-216-4426
Mailing address:
  • Phone: 716-216-4424
  • Fax: 716-216-4426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number455196
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number333243
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: