Provider Demographics
NPI:1376622779
Name:MASI, NINA (OD)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:
Last Name:MASI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 TIMBER DR
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-1753
Mailing Address - Country:US
Mailing Address - Phone:908-226-5111
Mailing Address - Fax:908-769-0092
Practice Address - Street 1:621 W EDGAR RD
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-6574
Practice Address - Country:US
Practice Address - Phone:908-474-9089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOA004763152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2049410OtherAETNA