Individual
RICHARD MAZZACCARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
CEDAR CREST BLVD & I-78, ALLENTOWN, PA 18103
(610) 402-6700
(610) 402-6744
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178
(484) 884-4500
(484) 884-0699
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD421920
PA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD421920
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101027932
—
PA
Enumeration date
07/07/2006
Last updated
10/17/2016
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