Provider Demographics
NPI:1821307430
Name:TRUSTY, MAZIE (NP)
Entity Type:Individual
Prefix:MRS
First Name:MAZIE
Middle Name:
Last Name:TRUSTY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HARRINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07642-2708
Mailing Address - Country:US
Mailing Address - Phone:201-358-1929
Mailing Address - Fax:
Practice Address - Street 1:8 HARRINGTON ST
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:NJ
Practice Address - Zip Code:07642-2708
Practice Address - Country:US
Practice Address - Phone:201-358-1929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJF0910055363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily