Provider Demographics
NPI:1043371032
Name:MAZZARELLI, GIOVANNI FRANCO (DC)
Entity Type:Individual
Prefix:MR
First Name:GIOVANNI
Middle Name:FRANCO
Last Name:MAZZARELLI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 HUSKY HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601
Mailing Address - Country:US
Mailing Address - Phone:845-462-7070
Mailing Address - Fax:845-462-7171
Practice Address - Street 1:25 HUSKY HILL ROAD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-462-7070
Practice Address - Fax:845-462-7171
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0073941111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U54078Medicare UPIN
NYX68581Medicare ID - Type Unspecified