Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 4823 | MA |
NPI | 1013211689 |
---|---|
Provider Name | Dr. Brittney Jaye Mazza |
First Address | Dartmouth, MA 02747-3111 |
Second Address | Boston, MA 02215-1274 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2010 |
Last Update Date | 22/12/2010 |