Provider Demographics
NPI:1598218182
Name:MASSAR, NATALIA KONSTANCJA (PMHNP)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:KONSTANCJA
Last Name:MASSAR
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 W 45TH ST FL 10
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4916
Mailing Address - Country:US
Mailing Address - Phone:516-505-7200
Mailing Address - Fax:
Practice Address - Street 1:555 NORTH AVE APT 12S
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-2414
Practice Address - Country:US
Practice Address - Phone:917-371-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY403782363LP0808X
NYF34440363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily