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General NPI Number Information
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NPI Number | 1760470272
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Entity Type | Individual
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Provider Name | MICHELLE MARIE MASON PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2301 E ALLEGHENY AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19134-4427
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Country | US
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Telephone | 215-291-3317
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Fax | 215-291-3315
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Provider Business Mailing Address
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Address Line | 5103 HALIFAX WAY
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054-6819
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Country | US
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Telephone | 856-727-6407
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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 | 28RI02792500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP438345
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License Number State | PA
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