Individual
VICKI KUMARI MASSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4 TECHNOLOGY DR, EAST SETAUKET, NY 11733-4080
(631) 444-4601
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 741-0549
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A141922
CA
2080P0214X
Pediatric Pulmonology Physician
Primary
301464-01
NY
Other
Enumeration date
05/22/2013
Last updated
12/18/2019
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