Provider Demographics
NPI:1114252780
Name:MAAS, JASON (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:MAAS
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 E 37TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3005
Mailing Address - Country:US
Mailing Address - Phone:212-239-2112
Mailing Address - Fax:212-239-4224
Practice Address - Street 1:19 E 37TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3005
Practice Address - Country:US
Practice Address - Phone:212-239-2112
Practice Address - Fax:212-239-4224
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011704-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical