Provider Demographics
NPI:1386985083
Name:MASON, WARREN PHILLIP (HIS)
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:PHILLIP
Last Name:MASON
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 JARVES ST
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-2041
Mailing Address - Country:US
Mailing Address - Phone:774-413-7353
Mailing Address - Fax:774-413-7484
Practice Address - Street 1:33 JARVES ST
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563-2041
Practice Address - Country:US
Practice Address - Phone:774-413-7353
Practice Address - Fax:774-413-7484
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA271-1237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist