Provider Demographics
NPI:1538135249
Name:MASOOD, SYED SIRAJ (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:SIRAJ
Last Name:MASOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1295 PORTLAND AVE
Mailing Address - Street 2:SUITE 17
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-2731
Mailing Address - Country:US
Mailing Address - Phone:585-467-5957
Mailing Address - Fax:585-467-7445
Practice Address - Street 1:1295 PORTLAND AVE
Practice Address - Street 2:SUITE 17
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-2731
Practice Address - Country:US
Practice Address - Phone:585-467-5957
Practice Address - Fax:585-467-7445
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY190369208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics