Provider Demographics
NPI:1306639018
Name:MASON MEDICAL PRACTICE PLLC
Entity type:Organization
Organization Name:MASON MEDICAL PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WISSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOYEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-922-1744
Mailing Address - Street 1:948 TODT HILL RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-1318
Mailing Address - Country:US
Mailing Address - Phone:718-887-2280
Mailing Address - Fax:718-887-2277
Practice Address - Street 1:265 MASON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3412
Practice Address - Country:US
Practice Address - Phone:718-887-2280
Practice Address - Fax:718-887-2277
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MASON MEDICAL PRACTICE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty