Individual
DONALD A MAZZULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MD.202150
LA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
MD.202150
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01784821
—
MS
05
—
1148342
—
LA
Enumeration date
07/02/2008
Last updated
10/05/2020
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