Individual
MS. MARY S MAZANEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
263381
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042297845
GREAT WEST HEALTH CARE
MA
01
—
042297845
MULTI-PLAN
—
05
—
0710661
—
MA
01
—
121285
FALLON
MA
01
—
NP5514
MEDICARE
MA
01
—
NP9628
BCBSMA
MA
Enumeration date
12/05/2006
Last updated
02/10/2011
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