Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 127475 | NY |
NPI | 1609090349 |
---|---|
Provider Name | Dr. Lawrence David Mass |
First Address | New York, NY 10010-3101 |
Second Address | New York, NY 10010-3101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 03/12/2012 |