Individual
RENUKA D MAZZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
218 WILLIAM FLOYD PKWY, SHIRLEY, NY 11967-3428
(631) 833-0537
Mailing address
218 WILLIAM FLOYD PKWY, SHIRLEY, NY 11967-3428
(631) 833-0537
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
3033071
NY
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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