Provider Demographics
NPI:1598918161
Name:MASTERSON, MAUREEN MARY (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:MARY
Last Name:MASTERSON
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Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:75 NEW SCOTLAND AVENUE
Mailing Address - Street 2:CAPITAL DISTRICT PSYCHIATRIC CENTER
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3409
Mailing Address - Country:US
Mailing Address - Phone:518-447-9611
Mailing Address - Fax:518-434-9164
Practice Address - Street 1:75 NEW SCOTLAND AVENUE
Practice Address - Street 2:CAPITAL DISTRICT PSYCHIATRIC CENTER
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3409
Practice Address - Country:US
Practice Address - Phone:518-447-9611
Practice Address - Fax:518-434-9164
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
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Provider Licenses
StateLicense IDTaxonomies
NYF401012-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health