Provider Demographics
NPI:1205141959
Name:MASON, MATILDA SYLVIA (MD)
Entity type:Individual
Prefix:DR
First Name:MATILDA
Middle Name:SYLVIA
Last Name:MASON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MATILDA
Other - Middle Name:SYLVIA
Other - Last Name:ANDOH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:651 WILLOW GROVE ST
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-1799
Mailing Address - Country:US
Mailing Address - Phone:908-441-1161
Mailing Address - Fax:973-383-4572
Practice Address - Street 1:651 WILLOW GROVE ST
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-1799
Practice Address - Country:US
Practice Address - Phone:908-441-1161
Practice Address - Fax:973-383-4572
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268687207R00000X
390200000X
NJ25MA09712200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program