Individual
OLGA MAZZEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
182 EMILY LN, STATEN ISLAND, NY 10312-6620
(646) 642-5407
Mailing address
182 EMILY LN, STATEN ISLAND, NY 10312-6620
(646) 642-5407
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
72111
NY
Other
Enumeration date
11/07/2012
Last updated
11/07/2012
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