Individual
DR. DOMINIC F MAZZOCCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 BEAVER DAM RD, POINT PLEASANT BEACH, NJ 08742-4970
(732) 295-0808
(732) 295-3845
Mailing address
702 CARNATION AVENUE, BRICK, NJ 08724
(732) 840-2378
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA04770300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0065873
GHI
NJ
05
—
0942006
—
NJ
01
—
110172484
RAILROAD MEDICARE
NJ
01
—
1K1007
HEALTHNET
NJ
01
—
223360408-006
QUALCARE
NJ
01
—
P414149
OXFORD
NJ
Enumeration date
02/10/2006
Last updated
07/08/2007
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