Provider Demographics
NPI:1265677876
Name:MASSARI, FERDINAND EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:FERDINAND
Middle Name:EDWARD
Last Name:MASSARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-4143
Mailing Address - Country:US
Mailing Address - Phone:978-998-4013
Mailing Address - Fax:
Practice Address - Street 1:268 E FALLKILL RD
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:12538-3025
Practice Address - Country:US
Practice Address - Phone:845-266-4690
Practice Address - Fax:845-266-8115
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-10
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY24034I1207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology