Provider Demographics
NPI:1568546869
Name:MAZZARELLI, GIULIO (DC)
Entity Type:Individual
Prefix:
First Name:GIULIO
Middle Name:
Last Name:MAZZARELLI
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 1:30 FIFTH AVENUE
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8859
Mailing Address - Country:US
Mailing Address - Phone:212-673-4331
Mailing Address - Fax:212-674-5971
Practice Address - Street 1:30 FIFTH AVENUE
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8859
Practice Address - Country:US
Practice Address - Phone:212-673-4331
Practice Address - Fax:212-674-5971
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYXYW101Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER