Mazzillo, Justin Adam
Mazzillo, Justin Adam is an individual health care provider with primary practice located at 590 Court St , Keene NH 03431-1719. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Mazzillo, Justin Adam can be contacted via phone (603) 354-5454.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | P1670 | Texas |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 16046 | New Hampshire |
Profile Details
| NPI number | 1487924304 |
|---|---|
| LBN Legal business name | Mazzillo, Justin Adam |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2012 |
| Last updated | Aug 28th, 2013 - about 12 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 | 1487924304 | NPPES |
| New Hampshire | MEDICAID | 3085790 |
Popular Providers
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Friese, Steven B.
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590 Court St , Keene NH 03431-1719