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NPI Code Detail

MEDICARE: KATIE ANN MASON

MEDICARE: KATIE ANN MASON
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
12084N0402XNeurology with Special Qualifications in Child Neurology Physician26NR24812800NJ

General Provider Information

NPI Number : 1639032048
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE ANN MASON
Provider Business Mailing Address
First Line : 255 3RD AVE
Second Line :
City : LONG BRANCH
State : NJ
Zip : 07740-6214
Country : US
Telephone Number : 732-923-7790
Fax Number :
Provider Business Practice Location Address
First Line : 255 3RD AVE
Second Line :
City : LONG BRANCH
State : NJ
Zip : 07740-6214
Country : US
Telephone Number : 732-923-7790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2025
Last Update Date : 12/03/2025

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Directions to “ KATIE ANN MASON ” Practice Location

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