# MS. MARY S MAZANEC

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1003974585
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0200X | Pediatric Nurse Practitioner | 263381 | MA | Yes |

## Other

- **Enumeration date:** 12/05/2006
- **Last updated:** 02/10/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 042297845 | PHCS | MA |
| 01 | — | 042297845 | MULTI-PLAN | — |
| 05 | — | 0710661 | — | MA |
| 01 | — | 121285 | FALLON | MA |
| 01 | — | NP5514 | MEDICARE | MA |
| 01 | — | NP9628 | BCBSMA | MA |