Organization
GASTROENTEROLOGY ASSOCIATES OF THE SOUTHERN TIER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUNO ROBERT MAZZA MD (PHYSICIAN)
(607) 734-7121
Entity
Organization
Contact information
Practice address
378 W CHURCH ST, ELMIRA, NY 14901-2621
(607) 734-7121
(607) 734-0614
Mailing address
378 W CHURCH ST, ELMIRA, NY 14901-2621
(607) 734-7121
(607) 734-0614
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN0726
RAILROAD MEDICARE GROUP #
NY
Enumeration date
09/20/2006
Last updated
04/10/2008
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