Provider Demographics
NPI:1356434757
Name:MASER, MARY JANE ELIZABETH (PHD, APRN, BC)
Entity type:Individual
Prefix:DR
First Name:MARY JANE
Middle Name:ELIZABETH
Last Name:MASER
Suffix:
Gender:F
Credentials:PHD, APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 BROAD ST
Mailing Address - Street 2:# 2
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2026
Mailing Address - Country:US
Mailing Address - Phone:732-741-4777
Mailing Address - Fax:732-741-3585
Practice Address - Street 1:214 BROAD ST
Practice Address - Street 2:# 2
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2026
Practice Address - Country:US
Practice Address - Phone:732-741-4777
Practice Address - Fax:732-741-3585
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC08121700364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ346090Medicare PIN