Provider Demographics
NPI:1508838020
Name:MASOOD, GULE-RANA (MD)
Entity Type:Individual
Prefix:DR
First Name:GULE-RANA
Middle Name:
Last Name:MASOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22410 N 53RD PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-7213
Mailing Address - Country:US
Mailing Address - Phone:585-467-9790
Mailing Address - Fax:585-467-9798
Practice Address - Street 1:22410 N 53RD PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-7213
Practice Address - Country:US
Practice Address - Phone:585-467-9790
Practice Address - Fax:585-467-9798
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190081207R00000X, 207RH0002X
AZ37219207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01649816Medicaid
NY101431BJOtherPREFERRED CARE
NY101431BJOtherPREFERRED CARE
NYDD0517Medicare PIN