Provider Demographics
NPI:1841390812
Name:MASTERSON, DEBORAH B (RNC)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:B
Last Name:MASTERSON
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:BECKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:227 JUDITH DR
Mailing Address - Street 2:
Mailing Address - City:STORMVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12582-5263
Mailing Address - Country:US
Mailing Address - Phone:845-229-1617
Mailing Address - Fax:
Practice Address - Street 1:82 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-2388
Practice Address - Country:US
Practice Address - Phone:845-486-3680
Practice Address - Fax:845-486-3690
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340597-1163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)