Provider Demographics
NPI:1861480295
Name:INOUYE, MASAYUKI (MD)
Entity Type:Individual
Prefix:DR
First Name:MASAYUKI
Middle Name:
Last Name:INOUYE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1999
Mailing Address - Country:US
Mailing Address - Phone:201-489-6520
Mailing Address - Fax:201-489-6530
Practice Address - Street 1:20 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1999
Practice Address - Country:US
Practice Address - Phone:201-489-6520
Practice Address - Fax:201-489-6530
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07251300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ049112Medicare ID - Type Unspecified
NJH41377Medicare UPIN