Provider Demographics
NPI:1346487626
Name:MASON, MERRION LORRAINE
Entity Type:Individual
Prefix:
First Name:MERRION
Middle Name:LORRAINE
Last Name:MASON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MERRION
Other - Middle Name:LORRAINE
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:293 VERSAILLES RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-1423
Mailing Address - Country:US
Mailing Address - Phone:585-771-7514
Mailing Address - Fax:
Practice Address - Street 1:293 VERSAILLES RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-1423
Practice Address - Country:US
Practice Address - Phone:585-771-7514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY549351-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse