Provider Demographics
NPI:1902972714
Name:DELNEGRO-MASON, MARY ANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:MARY ANNE
Middle Name:
Last Name:DELNEGRO-MASON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:GARWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07027-1042
Mailing Address - Country:US
Mailing Address - Phone:908-789-2303
Mailing Address - Fax:908-789-2304
Practice Address - Street 1:332 NORTH AVE
Practice Address - Street 2:
Practice Address - City:GARWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07027-1042
Practice Address - Country:US
Practice Address - Phone:908-789-2303
Practice Address - Fax:908-789-2304
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMCO2420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ520304Medicare PIN
NJT45660Medicare UPIN