Individual
DR. NICHOLAS T MASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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