Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 248591 | NY |
NPI | 1457599797 |
---|---|
Provider Name | Dr. Nicole Aliza Mazer |
First Address | Flushing, NY 11355-5044 |
Second Address | Bayside, NY 11360-2452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2009 |
Last Update Date | 14/09/2012 |