Individual
TANIA MASON-EASTMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5301 BROADWAY, WEST NEW YORK, NJ 07093-2622
(201) 866-9320
(201) 867-9183
Mailing address
73 HARBOR KY, SECAUCUS, NJ 07094-2203
(201) 865-7342
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
25MB07026100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8330603
—
NJ
Enumeration date
07/21/2006
Last updated
03/13/2012
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