Provider Demographics
NPI:1518745397
Name:MASON, RASHEDA (RN)
Entity Type:Individual
Prefix:
First Name:RASHEDA
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 GARDNER AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-3014
Mailing Address - Country:US
Mailing Address - Phone:917-803-1342
Mailing Address - Fax:
Practice Address - Street 1:54 GARDNER AVE APT 2
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-3014
Practice Address - Country:US
Practice Address - Phone:917-803-1342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY802329163W00000X
NJ2NR25005600163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse