Provider Demographics
NPI:1275602328
Name:MAZURKIEWICZ, THOMAS M (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:MAZURKIEWICZ
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 1:184 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-2113
Mailing Address - Country:US
Mailing Address - Phone:585-343-9316
Mailing Address - Fax:585-344-7031
Practice Address - Street 1:184 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-2113
Practice Address - Country:US
Practice Address - Phone:585-343-9316
Practice Address - Fax:585-344-7031
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002921111N00000X
NYX002921-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8809348OtherINDEPENDENT HEALTH
NY8809348OtherINDEPENDENT HEALTH