Organization
SEBASTIAN A MAZZOTTA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINE ANNE LAQUIER (OFFICE MANAGER)
(315) 386-8141
Entity
Organization
Contact information
Practice address
4 STILLMAN DR, CANTON, NY 13617-1221
(315) 386-8141
(315) 386-8493
Mailing address
4 STILLMAN DR, CANTON, NY 13617-1221
(315) 386-8141
(315) 386-8493
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
130060
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00630699
—
NY
Enumeration date
12/17/2010
Last updated
07/09/2015
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