Provider Demographics
NPI:1285777052
Name:MASI, SALVATORE J (DC)
Entity type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:J
Last Name:MASI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 GERARD ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6944
Mailing Address - Country:US
Mailing Address - Phone:631-425-2600
Mailing Address - Fax:631-425-3098
Practice Address - Street 1:46 GERARD ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-6944
Practice Address - Country:US
Practice Address - Phone:631-425-2600
Practice Address - Fax:631-425-3098
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400014765OtherMEDICARE PTAN
NYP1118035OtherOXFORD
NYX96341OtherBCBS
NY5033688OtherAETNA
NYX96341OtherBCBS
NYA400014765Medicare PIN