Provider Demographics
NPI:1801822887
Name:MASS, BURTON (MD)
Entity Type:Individual
Prefix:DR
First Name:BURTON
Middle Name:
Last Name:MASS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BURTON
Other - Middle Name:
Other - Last Name:NASS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1250 GREENWOOD AVE
Mailing Address - Street 2:327
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2901
Mailing Address - Country:US
Mailing Address - Phone:215-886-4412
Mailing Address - Fax:
Practice Address - Street 1:1250 GREENWOOD AVE
Practice Address - Street 2:327
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2901
Practice Address - Country:US
Practice Address - Phone:215-886-4412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD9685E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006597440001Medicaid
PAC28034Medicare UPIN
PA031820Medicare ID - Type Unspecified