Individual
MR. VICTOR JOSEPH MAZZARACO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
777 SEAVIEW AVE, STATEN ISLAND, NY 10305-3409
(718) 667-2648
Mailing address
777 SEAVIEW AVE, STATEN ISLAND, NY 10305-3409
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
789188
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2997157
—
NY
Enumeration date
01/22/2024
Last updated
01/22/2024
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