Provider Demographics
NPI:1144419326
Name:MOZDY, LAUREN M (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:MOZDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3233 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-2507
Mailing Address - Country:US
Mailing Address - Phone:814-833-1756
Mailing Address - Fax:814-833-1671
Practice Address - Street 1:3233 W 26TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-2507
Practice Address - Country:US
Practice Address - Phone:814-833-1756
Practice Address - Fax:814-833-1671
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD057038L207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine