Individual
FERNANDE MAZILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7428 87TH AVE, WOODHAVEN, NY 11421-1836
(347) 969-1624
Mailing address
7428 87TH AVE, WOODHAVEN, NY 11421-1836
(347) 969-1624
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
33338922
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174843908
—
NY
Enumeration date
06/03/2010
Last updated
10/20/2014
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