Provider Demographics
NPI:1407009095
Name:RJ MASAKAYAN MD PC
Entity Type:Organization
Organization Name:RJ MASAKAYAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:MASAKAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-246-9276
Mailing Address - Street 1:32 SETALCOTT PL
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1326
Mailing Address - Country:US
Mailing Address - Phone:631-246-9276
Mailing Address - Fax:
Practice Address - Street 1:32 SETALCOTT PL
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-1326
Practice Address - Country:US
Practice Address - Phone:631-246-9276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2114121207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty