Provider Demographics
NPI:1811014210
Name:ARSHAD MASOOD ,PHYSICIAN ,PC
Entity Type:Organization
Organization Name:ARSHAD MASOOD ,PHYSICIAN ,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MASOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-392-4114
Mailing Address - Street 1:1024 HILTON PARMA RD
Mailing Address - Street 2:PO BOX 835
Mailing Address - City:HILTON
Mailing Address - State:NY
Mailing Address - Zip Code:14468-9328
Mailing Address - Country:US
Mailing Address - Phone:585-392-4114
Mailing Address - Fax:
Practice Address - Street 1:1024 HILTON PARMA RD
Practice Address - Street 2:
Practice Address - City:HILTON
Practice Address - State:NY
Practice Address - Zip Code:14468-9328
Practice Address - Country:US
Practice Address - Phone:585-392-4114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2010-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190170261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01674006Medicaid
NYAA1229Medicare ID - Type Unspecified
NY01674006Medicaid