Provider Demographics
NPI:1356658272
Name:MASON, NANCY G (RPHR)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:G
Last Name:MASON
Suffix:
Gender:F
Credentials:RPHR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 WESTFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1529
Mailing Address - Country:US
Mailing Address - Phone:908-202-6461
Mailing Address - Fax:
Practice Address - Street 1:877 SAINT GEORGE AVE
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-2514
Practice Address - Country:US
Practice Address - Phone:732-636-4151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ19364183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist