Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 25MB08219200 | NJ |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 501015425 | MI |
NPI | 1629192463 |
---|---|
Provider Name | Dr. Thomas Frank Mazzoni |
First Address | Tarrytown, NY 10591-5107 |
Second Address | Iselin, NJ 08830-0883 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 30/12/2021 |