Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 047653 | CT |
Y | 2080P0210X | Pediatric Nephrologist | 047653 | CT |
NPI | 1548442494 |
---|---|
Provider Name | Dr. Sherene Mason |
First Address | Hartford, CT 06106-3322 |
Second Address | Hartford, CT 06106-3322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2007 |
Last Update Date | 15/05/2013 |