Provider Demographics
NPI:1295379105
Name:REITER, MASON (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:MASON
Middle Name:
Last Name:REITER
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5595 TRANSPORTATION BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-5359
Mailing Address - Country:US
Mailing Address - Phone:216-587-5431
Mailing Address - Fax:
Practice Address - Street 1:5595 TRANSPORTATION BLVD STE 220
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-5359
Practice Address - Country:US
Practice Address - Phone:216-587-5431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.025771363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner