Individual
STUART J MASTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 STATE RTE 20, NEW LEBANON, NY 12125
(518) 794-7216
(518) 794-0180
Mailing address
PO BOX 417, NEW LEBANON, NY 12125-0417
(518) 794-7216
(518) 794-0180
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
38710
MA
2085R0202X
Diagnostic Radiology Physician
232465
NY
2085R0202X
Diagnostic Radiology Physician
Primary
38710
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00579951
—
NY
05
—
2045281
—
MA
01
—
728S71
MEDICARE
NY
Enumeration date
09/20/2005
Last updated
12/03/2007
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