| Doctor Name: | MISS BETHANIE PATRICIA MASON |
| NPI Number: | 1790139632 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 22681633 |
| Business Practice Address: | 16887 Roosevelt Hwy Kendall, NY - 144769748 |
| Business Phone Number: | 5856598958 |
| Business Fax Number: | 5856598988 |
| Mailing Address: | 16887 Roosevelt Hwy, KENDALL |
| State: | NY |
| Postal Code: | 144769748 |
| Phone Number: | 5856598958 |
| Fax Number: | 5856598988 |
| NPI Enumeration Date: | 04/18/2016 |
| NPI Last Update Date: | 04/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | 22681633 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |