| Organization Name: | MASONICARE |
| NPI Number: | 1104131283 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN FAGAN (REHAB DIRECTOR) |
| Mailing Address: | 22 Masonic Ave Rehab Department Wallingford |
| State: | CT US |
| Postal Code: | 064923048 |
| Phone Number: | 2036795900 |
| Fax Number: | 2036796142 |
| NPI Enumeration Date: | 08/12/2010 |
| NPI Last Update Date: | 08/12/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 283X00000X |
| License Number: | 003288 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Rehabilitation Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A hospital or facility that provides health-related, social and/or vocational services to disabled persons to help them attain their maximum functional capacity. |