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Provider Information for 1831163658

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DAVID DEMASO MD

Gender: MALE

Individual NPI: 1831163658

Calendar   Last Updated:  2014-07-14
  Certification Date: 

Details

Name Value
NPI 1831163658
Enumeration Date 2006-02-16
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address PO BOX 845628
BOSTON, MA 02284-5628
United States

Phone: 800-927-0002 | Fax:
View Map External Link
Primary Practice Address 300 LONGWOOD AVE
BOSTON, MA 02115-5724
United States

Phone: 617-355-6793 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID RI DD03666
MEDICAID NY 1098695
MEDICAID MA 0124966
MEDICAID NH 30002847
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 2084P0804X - Psychiatry & Neurology Child & Adolescent Psychiatry MA 43777