MEDICARE: MS. ANTOINETTE MASE NP

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
1	207RC0000X	Cardiovascular Disease Physician	687020	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	F345004-01	NY

General Provider Information

NPI Number	:	1851952212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANTOINETTE MASE NP

Provider Business Mailing Address
First Line	:	406 WALKER ST
Second Line	:
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-3017
Country	:	US
Telephone Number	:	516-993-9747
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 HILTON AVE STE 103
Second Line	:
City	:	HEMPSTEAD
State	:	NY
Zip	:	11550-8116
Country	:	US
Telephone Number	:	516-464-0266
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2019
Last Update Date	:	06/10/2026

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