Provider Demographics
NPI:1881965069
Name:MASON, DARIUS LOUIS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DARIUS
Middle Name:LOUIS
Last Name:MASON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ALICE LN
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144-9614
Mailing Address - Country:US
Mailing Address - Phone:901-568-1802
Mailing Address - Fax:
Practice Address - Street 1:25 HACKETT BLVD
Practice Address - Street 2:MC 69
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3462
Practice Address - Country:US
Practice Address - Phone:518-262-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000239911835P1200X
IN051.2912541835P1200X
NY053549-11835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy