Masonic Medical Research Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MASONIC MEDICAL RESEARCH LABORATORY

Practice address

2150 Bleecker St
Utica, NY 13501-1738

Phone

(315) 735-2217

NPI assigned

Mar 2, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan Bartkowiak

Title

Director of Administration

Phone

(315) 624-7487

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1508451527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 BLEECKER ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135011738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 BLEECKER ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135011738",
            "telephone_number": "315-735-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASONIC MEDICAL RESEARCH LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "BARTKOWIAK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
        "authorized_official_telephone_number": "315-624-7487"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Martorella
• Teresa Martorella, MD
• Jerilyn R Mashaw, RPH
• Joseph Mashaw
• Tamie Marie Mason
• Hamza Masood, MD
• Cassie Renee Massicotte, PA-C
• Lauren Mastrangelo, LCSW
• Mathew J Ulahannan MD PC
• Priya M Mathew, RD

• Clinical Medical Laboratory in Utica, NY
• Providers in Utica, NY by specialty
• Clinical Medical Laboratory in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.