Individual
DR. NICHOLAS T MASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
475 IRVING AVE STE 210, SYRACUSE, NY 13210-1529
(315) 471-2646
(315) 471-1762
Mailing address
475 IRVING AVE STE 210, SYRACUSE, NY 13210-1529
(315) 471-1761
(315) 471-1762
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
228568
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000154336
EXCELLUS BC BS
NY
01
—
161352271
UNITED HEALTH CARE
NY
01
—
669691
MVP
NY
01
—
7434514
AETNA
NY
Enumeration date
10/12/2006
Last updated
06/11/2012
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