Provider Demographics
NPI:1427217678
Name:MAZURKIEWICZ, REBECCA ANNE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ANNE
Last Name:MAZURKIEWICZ
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Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:100 E 77TH ST
Mailing Address - Street 2:DEPARTMENT OF MEDICINE - 6 BLACK HALL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1850
Mailing Address - Country:US
Mailing Address - Phone:212-434-2140
Mailing Address - Fax:212-434-2446
Practice Address - Street 1:100 E 77TH ST
Practice Address - Street 2:DEPARTMENT OF MEDICINE - 6 BLACK HALL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1850
Practice Address - Country:US
Practice Address - Phone:212-434-2140
Practice Address - Fax:212-434-2446
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2012-08-01
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NY250118207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program