Provider Demographics
NPI:1275981656
Name:MASTERSON, ALISE
Entity Type:Individual
Prefix:
First Name:ALISE
Middle Name:
Last Name:MASTERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALISE
Other - Middle Name:
Other - Last Name:CURRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:121 N BROADWAY
Mailing Address - Street 2:APT 32G
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-3638
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:121 N BROADWAY
Practice Address - Street 2:APT 32G
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-3638
Practice Address - Country:US
Practice Address - Phone:914-263-0603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist