Individual
PETER JOSEPH MAZZAGLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 DUDLEY ST, SUITE 470, PROVIDENCE, RI 02905-3236
(401) 223-0962
(401) 861-1272
Mailing address
PO BOX 16149, RUMFORD, RI 02916-0697
(401) 453-9625
(401) 435-7069
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD12186
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31703-4
RHODE ISLAND BCBS
RI
05
—
7058687
—
RI
Enumeration date
07/10/2006
Last updated
01/29/2020
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