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Individual

MASON LYKES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
TATTOO ARTIST

Contact information

Practice address
160 MADISON AVE STE 6, NEW YORK, NY 10016-5412
(929) 434-8004
Mailing address
167 ALLEN ST APT 2C, NEW YORK, NY 10002-2155
(646) 331-2359

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
50107436
NY
246ZA2600X
Medical Art Specialist/Technologist
50107436
NY
261Q00000X
Clinic/Center
374700000X
Technician
50107436
NY

Other

Enumeration date
05/09/2021
Last updated
05/09/2021
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