Provider Demographics
NPI:1558689414
Name:MASOOD, FAISAL (DC)
Entity Type:Individual
Prefix:MR
First Name:FAISAL
Middle Name:
Last Name:MASOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17860 WEXFORD TER APT 5E
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3022
Mailing Address - Country:US
Mailing Address - Phone:347-659-6559
Mailing Address - Fax:
Practice Address - Street 1:17860 WEXFORD TER APT 5E
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3022
Practice Address - Country:US
Practice Address - Phone:347-659-6559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011898-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor