Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 025528 | CT |
N | 111NI0900X | Internist | 025528 | CT |
Y | 207RG0300X | Geriatric Medicine | 25528 | CT |
NPI | 1003879446 |
---|---|
Provider Name | Pasquale Masone |
First Address | Bridgeport, CT 06606-4237 |
Second Address | Bridgeport, CT 06606-4237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 15/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001255280 | (05) | CT |
D02842 | (02) |