Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 288840 | NY |
N | 111NI0900X | Internist | 288840 | NY |
N | 207RC0200X | Critical Care Medicine | 288840 | NY |
Y | 207RP1001X | Pulmonary Disease | 288840 | NY |
NPI | 1063709988 |
---|---|
Provider Name | Dr. Ross Eliott Mazo |
First Address | New York, NY 10011-3221 |
Second Address | West Harrison, NY 10604-2901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2011 |
Last Update Date | 08/09/2017 |