Individual
JOHN M MAZUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-T,CRPA,NYCPS-P
Contact information
Practice address
1213 COURT ST, UTICA, NY 13502-3803
(315) 624-9835
Mailing address
2529 FISH CREEK RD, CONSTABLEVILLE, NY 13325-1816
(315) 832-8418
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
38948
NY
175T00000X
Peer Specialist
CRPA-5954
NY
175T00000X
Peer Specialist
NYCPS-P-5843
NY
175T00000X
Peer Specialist
VSR-5013
NY
Other
Enumeration date
03/25/2024
Last updated
03/29/2025
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