Healthcare Provider Details

I. General information

NPI: 1306639018
Provider Name (Legal Business Name): MASON MEDICAL PRACTICE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2025
Last Update Date: 05/26/2025
Certification Date: 05/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 MASON AVE
STATEN ISLAND NY
10305-3412
US

IV. Provider business mailing address

948 TODT HILL RD
STATEN ISLAND NY
10304-1318
US

V. Phone/Fax

Practice location:
  • Phone: 718-887-2280
  • Fax: 718-887-2277
Mailing address:
  • Phone: 718-887-2280
  • Fax: 718-887-2277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: WISSAM HOYEK
Title or Position: OWNER
Credential: MD
Phone: 917-922-1744