Provider Demographics
NPI:1457708992
Name:MASRI, KUZIDA
Entity type:Individual
Prefix:
First Name:KUZIDA
Middle Name:
Last Name:MASRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 N DENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1154
Mailing Address - Country:US
Mailing Address - Phone:313-717-1867
Mailing Address - Fax:
Practice Address - Street 1:1840 N DENWOOD ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48128-1154
Practice Address - Country:US
Practice Address - Phone:313-717-1867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-14
Last Update Date:2016-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other