Provider Demographics
NPI:1598807240
Name:MASER, BARRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
Last Name:MASER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:MR
Other - First Name:BARRY
Other - Middle Name:
Other - Last Name:MASER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:401 LYNN ST
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07640-1119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:888 GRAND CONCOURSE
Practice Address - Street 2:4E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-2802
Practice Address - Country:US
Practice Address - Phone:718-665-8792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1008150001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY26518OtherNY STATE LICENSE
NJ2804OtherSPECIALTY PERMIT NUMBER
NY00641456Medicaid