Provider Demographics
NPI:1851058895
Name:MASSA MEDICAL LLC
Entity Type:Organization
Organization Name:MASSA MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAHER
Authorized Official - Middle Name:
Authorized Official - Last Name:KHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:PHT
Authorized Official - Phone:301-599-9500
Mailing Address - Street 1:4602 BELLE DOR TRCE
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4685
Mailing Address - Country:US
Mailing Address - Phone:202-378-7558
Mailing Address - Fax:301-805-4472
Practice Address - Street 1:4602 BELLE DOR TRCE
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4685
Practice Address - Country:US
Practice Address - Phone:202-378-7558
Practice Address - Fax:301-805-4472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-24
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental ModificationGroup - Single Specialty