Individual
DR. BRUNO ROBERT MAZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 SAINT JOSEPHS BLVD STE M2, ELMIRA, NY 14901-3223
(607) 734-7121
(607) 734-0614
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
(607) 873-1244
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
131718
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00584616
—
NY
05
—
102786210
—
NY
Enumeration date
08/30/2006
Last updated
11/25/2020
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