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NPI Code Detail

MEDICARE: MARTIN MASARECH MD

MEDICARE: MARTIN MASARECH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician158655NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356341622
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTIN MASARECH MD
Provider Business Mailing Address
First Line : 346 GRAND AVE
Second Line :
City : JOHNSON CITY
State : NY
Zip : 13790-2580
Country : US
Telephone Number : 607-729-8156
Fax Number : 607-729-3982
Provider Business Practice Location Address
First Line : 15 BIRDSALL ST
Second Line :
City : GREENE
State : NY
Zip : 13778-1057
Country : US
Telephone Number : 607-656-4115
Fax Number : 607-656-9553
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 11/29/2011

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Directions to “ MARTIN MASARECH MD” Practice Location

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