Provider Demographics
NPI:1861469884
Name:MASOOD, ANWER U (MD)
Entity type:Individual
Prefix:
First Name:ANWER
Middle Name:U
Last Name:MASOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 PORTLAND AVE
Mailing Address - Street 2:SUITE G-03
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3036
Mailing Address - Country:US
Mailing Address - Phone:585-342-4382
Mailing Address - Fax:585-342-2903
Practice Address - Street 1:1445 PORTLAND AVE
Practice Address - Street 2:SUITE G-03
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3036
Practice Address - Country:US
Practice Address - Phone:585-342-4382
Practice Address - Fax:585-342-2903
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110407207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC58132Medicare ID - Type Unspecified