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Individual

MR. CARMINIE MAZZARELLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.D.O.

Contact information

Practice address
739 BROADWAY, SAUGUS, MA 01906-3207
(781) 231-1097
Mailing address
739 BROADWAY, SAUGUS, MA 01906-3207
(781) 231-1097

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
4717
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
11013221A
MA
Enumeration date
07/22/2009
Last updated
07/22/2009
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