Provider Demographics
NPI:1326012766
Name:ENEYNI, MAZEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MAZEN
Middle Name:
Last Name:ENEYNI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02351-2424
Mailing Address - Country:US
Mailing Address - Phone:781-871-3773
Mailing Address - Fax:
Practice Address - Street 1:536 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:MA
Practice Address - Zip Code:02351-2424
Practice Address - Country:US
Practice Address - Phone:781-871-3773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA789832084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0500278OtherUNITED HEALTHCARE
MA043481427OtherTRICARE
MA6164416005OtherCIGNA
MA000000005865OtherBUMC HEALTHNET
MA3182231Medicaid
MA0264152OtherAETNA
MA078983OtherTUFTS
MA111009OtherHARVARD PILGRIM
MA1300242173OtherRAIL ROAD MEDICARE
MAJ18987OtherBCBS
MA0013521OtherNEIGHBORHOOD HEALTH
MA1300242173OtherRAIL ROAD MEDICARE
MAA28686Medicare PIN