Provider Demographics
NPI:1225053044
Name:MAZLIN & SHAW, M.D.'S PC
Entity Type:Organization
Organization Name:MAZLIN & SHAW, M.D.'S PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAZLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-517-9048
Mailing Address - Street 1:53 E 67TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-5962
Mailing Address - Country:US
Mailing Address - Phone:212-517-9048
Mailing Address - Fax:212-517-2847
Practice Address - Street 1:53 E 67TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5962
Practice Address - Country:US
Practice Address - Phone:212-517-9048
Practice Address - Fax:212-517-2847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW32941Medicare ID - Type Unspecified