Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 183345 | NY |
NPI | 1306802020 |
---|---|
Provider Name | Dr. Paula Marie Mazur |
First Address | Amherst, NY 14226-3822 |
Second Address | Buffalo, NY 14222-2006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 08/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00010113401 | UNIVERA (01) | |
000510987001 | BC/BS (01) | |
0010946920003 | (05) | PA |
01201110 | (05) | NY |
040426001871 | FIDELIS (01) | |
3905808 | IHA (01) | |
E12978 | (02) |