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General NPI Number Information
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NPI Number | 1730321191
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Entity Type | Individual
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Provider Name | RICHARD MASON R.PH.
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Gender | Male
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 04/01/2009
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Provider Practice Location Address
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Address Line | 4422 3RD AVE PHARMACY DEPT
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City | BRONX
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State | NY
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Zip | 10457-2545
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Country | US
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Telephone | 718-960-6699
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Fax | 718-960-6855
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Provider Business Mailing Address
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Address Line | 2102 SENECA DR S
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City | MERRICK
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State | NY
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Zip | 11566-3610
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Country | US
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Telephone | 516-546-9724
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 027092
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License Number State | NY
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