Provider Demographics
NPI:1013230531
Name:MASON, ROBERT T (PHARMD, MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:T
Last Name:MASON
Suffix:
Gender:M
Credentials:PHARMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13525 LEFFERTS BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-3601
Mailing Address - Country:US
Mailing Address - Phone:718-843-3900
Mailing Address - Fax:
Practice Address - Street 1:13525 LEFFERTS BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-3601
Practice Address - Country:US
Practice Address - Phone:718-843-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30920183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist