Individual
DR. ANNA MARRISSA MAZOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
45 2ND STREET PIKE STE 100, SOUTHAMPTON, PA 18966-3829
(633) 345-6215
(215) 396-3456
Mailing address
1648 HUNTINGDON PIKE, MEDICAL STAFF OFFICE FIRST FLOOR, MEADOWBROOK, PA 19046-8001
(215) 938-3450
(215) 938-3829
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
OS018407
PA
208600000X
Surgery Physician
OT014677
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OT014677
—
PA
Enumeration date
05/20/2012
Last updated
08/23/2019
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