Provider Demographics
NPI:1861882185
Name:GASTWIRTH-MASONE, JUDY
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:GASTWIRTH-MASONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WESTGATE LN
Mailing Address - Street 2:UNIT B
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-6393
Mailing Address - Country:US
Mailing Address - Phone:516-633-2185
Mailing Address - Fax:
Practice Address - Street 1:2 WESTGATE LN
Practice Address - Street 2:UNIT B
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-6393
Practice Address - Country:US
Practice Address - Phone:516-633-2185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000674231H00000X
FLAY1905231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist