Provider Demographics
NPI:1427229434
Name:ANNE C. MAZONSON, MD,LLC
Entity Type:Organization
Organization Name:ANNE C. MAZONSON, MD,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZONSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-657-5655
Mailing Address - Street 1:4807 SAINT ELMO AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-7044
Mailing Address - Country:US
Mailing Address - Phone:301-657-5655
Mailing Address - Fax:301-657-2814
Practice Address - Street 1:4807 SAINT ELMO AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-7044
Practice Address - Country:US
Practice Address - Phone:301-657-5655
Practice Address - Fax:301-657-2814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD418212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG01869OtherGROUP NUMBER