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Individual

MASON C GASPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
900 RESERVOIR AVE STE 1, CRANSTON, RI 02910-4453
(401) 714-0222
(401) 714-0220
Mailing address
900 RESERVOIR AVE STE 1, CRANSTON, RI 02910-4453
(401) 714-0222
(401) 714-0220

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
223324
MA
2084N0400X
Neurology Physician
Primary
DO00611
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007058833
MEDICARE PTAN
RI
01
042472266
TRICARE CHAMPUS
01
2102242
MEDICAID WELFARE
05
2102242
MA
01
468304
TUFTS HEALTH PLAN
01
5623315
FIRST HEALTH
05
7058831
RI
01
7238673
AETNA US HEALTHCARE
01
87317
HEALTHY START
01
92597
FALLON COMMUNITY HEALTH P
01
A3870402
MEDICARE PTAN
RI
01
AA34401
HARVARD PILGRIM HEALTHCAR
01
J29259
BLUE CARE ELECT
Enumeration date
11/10/2005
Last updated
11/14/2019
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