Provider Demographics
NPI:1346290129
Name:MASONE, JAMES VINCENT (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:VINCENT
Last Name:MASONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5140
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-1104
Mailing Address - Country:US
Mailing Address - Phone:631-476-7330
Mailing Address - Fax:631-642-9242
Practice Address - Street 1:29 MILLER WOODS DR
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-1524
Practice Address - Country:US
Practice Address - Phone:631-476-7330
Practice Address - Fax:631-642-9242
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008311111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor