Provider Demographics
NPI:1497292866
Name:MAZUREK, LAUREN (CNIM)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MAZUREK
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 WHITE PINE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08515-2206
Mailing Address - Country:US
Mailing Address - Phone:609-923-3651
Mailing Address - Fax:888-539-3001
Practice Address - Street 1:153 WHITE PINE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08515-2206
Practice Address - Country:US
Practice Address - Phone:609-923-3651
Practice Address - Fax:888-539-3001
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3284246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3284OtherLICENSE