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General NPI Number Information
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NPI Number | 1306639018
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Entity Type | Organization
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Legal Business Name | MASON MEDICAL PRACTICE PLLC
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Dates
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Enumeration Date | 05/26/2025
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Last Update Date | 05/26/2025
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Provider Practice Location Address
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Address Line | 265 MASON AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3412
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Country | US
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Telephone | 718-887-2280
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Fax | 718-887-2277
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Provider Business Mailing Address
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Address Line | 948 TODT HILL RD
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City | STATEN ISLAND
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State | NY
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Zip | 10304-1318
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Country | US
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Telephone | 718-887-2280
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Fax | 718-887-2277
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Authorized Official
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Title or Position | OWNER
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Name | WISSAM HOYEK
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Credential | MD
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Telephone | 917-922-1744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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