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General NPI Number Information
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NPI Number | 1780820308
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Entity Type | Individual
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Provider Name | JOHN ALFRED MASSO N.P.
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Gender | Male
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Dates
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Enumeration Date | 01/02/2009
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Last Update Date | 06/01/2015
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Provider Practice Location Address
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Address Line | 718 TEANECK RD HOME CARE DEPARTMENT
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City | TEANECK
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State | NJ
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Zip | 07666-4245
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Country | US
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Telephone | 201-833-3740
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Fax | 201-833-3164
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Provider Business Mailing Address
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Address Line | 718 TEANECK RD HOME CARE DEPARTMENT
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City | TEANECK
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State | NJ
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Zip | 07666-4245
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Country | US
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Telephone | 201-833-3740
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Fax | 201-833-3164
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NN09059000
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License Number State | NJ
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