Provider Demographics
NPI:1821122722
Name:MASOOD, YASMIN (MD)
Entity Type:Individual
Prefix:
First Name:YASMIN
Middle Name:
Last Name:MASOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-1256
Mailing Address - Country:US
Mailing Address - Phone:201-494-1802
Mailing Address - Fax:
Practice Address - Street 1:924 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-2155
Practice Address - Country:US
Practice Address - Phone:201-882-8422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT060-0003271207RC0000X
NJ25MA10477100207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease