Individual
LISA C MAZUR
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
4755 OGLETOWN-STANTON ROAD, NEWARK, DE 19718-0001
(302) 733-1000
(302) 733-1633
Mailing address
PO BOX 3048, WILMINGTON, DE 19804-0048
(302) 224-5678
(302) 224-2848
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C50000131
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000756943
—
DE
Enumeration date
01/03/2006
Last updated
07/08/2007
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