Provider Demographics
NPI:1609530005
Name:MINIMALLY INVASIVE FOOT & ANKLE SPECIALIST
Entity Type:Organization
Organization Name:MINIMALLY INVASIVE FOOT & ANKLE SPECIALIST
Other - Org Name:TRI-STATE TOP FOOT SPECIALIST - WESTCHESTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HASAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MASOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:845-536-8826
Mailing Address - Street 1:275 BRANDYWINE DR
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-2602
Mailing Address - Country:US
Mailing Address - Phone:845-536-8826
Mailing Address - Fax:
Practice Address - Street 1:222 MAMARONECK AVE STE 310
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1316
Practice Address - Country:US
Practice Address - Phone:914-222-0115
Practice Address - Fax:702-852-0631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-22
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty