Individual
ANDREA MAZZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
82 QUAIL RUN DR, DEER PARK, NY 11729-5633
(631) 243-2832
Mailing address
82 QUAIL RUN DR, DEER PARK, NY 11729-5633
(631) 243-2832
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
259561
NY
Other
Enumeration date
12/07/2012
Last updated
12/07/2012
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