Mazza, Bruno Robert
Mazza, Bruno Robert is an individual health care provider with primary practice located at 555 Saint Josephs Blvd Ste M2 , Elmira NY 14901-3223. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Mazza, Bruno Robert can be contacted via phone (607) 734-7121.Contact Information
Primary practice address
555 Saint Josephs Blvd Ste M2
Elmira NY 14901-3223
Phone: (607) 734-7121
Fax: (607) 734-0614
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 131718 | New York |
Profile Details
| NPI number | 1356450381 |
|---|---|
| LBN Legal business name | Mazza, Bruno Robert |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Nov 25th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356450381 | NPPES |
| New York | MEDICAID | 102786210 | |
| New York | MEDICAID | 00584616 |
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