Healthcare Provider Details
I. General information
NPI: 1043447659
Provider Name (Legal Business Name): ERIN M MASABA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/22/2009
Last Update Date: 06/29/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 RED CREEK DR SUITE 220
ROCHESTER NY
14623-4284
US
IV. Provider business mailing address
500 RED CREEK DR SUITE 220
ROCHESTER NY
14623-4284
US
V. Phone/Fax
- Phone: 585-487-3378
- Fax:
- Phone: 585-487-3378
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VE0102X |
| Taxonomy | Reproductive Endocrinology Physician |
| License Number | 267984 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: