Provider Demographics
NPI:1144563719
Name:MASOOD MEDICAL P.C.
Entity Type:Organization
Organization Name:MASOOD MEDICAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OMER
Authorized Official - Middle Name:K
Authorized Official - Last Name:MASOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-307-0980
Mailing Address - Street 1:30 NEWBRIDGE RD LOWR LEVEL1
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-2150
Mailing Address - Country:US
Mailing Address - Phone:516-307-0980
Mailing Address - Fax:516-307-0960
Practice Address - Street 1:30 NEWBRIDGE RD
Practice Address - Street 2:SUITE LL1
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2150
Practice Address - Country:US
Practice Address - Phone:516-307-0960
Practice Address - Fax:516-307-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL230809-1207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty