Provider Demographics
NPI:1841417128
Name:MASSON, VIVEK (MD)
Entity Type:Individual
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First Name:VIVEK
Middle Name:
Last Name:MASSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:11995 SINGLETREE LN
Mailing Address - Street 2:SUITE 500
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-5347
Mailing Address - Country:US
Mailing Address - Phone:952-959-1301
Mailing Address - Fax:612-294-4903
Practice Address - Street 1:721 5TH AVE
Practice Address - Street 2:APT 36A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2523
Practice Address - Country:US
Practice Address - Phone:952-595-1100
Practice Address - Fax:612-294-4903
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2012-12-12
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Provider Licenses
StateLicense IDTaxonomies
NY232747-12085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology