Provider Demographics
NPI:1952333163
Name:MAZEFSKY, LEONARD D (DPM)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:D
Last Name:MAZEFSKY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 WYOLA ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15211-1135
Mailing Address - Country:US
Mailing Address - Phone:412-904-3410
Mailing Address - Fax:
Practice Address - Street 1:419 WYOLA ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15211-1135
Practice Address - Country:US
Practice Address - Phone:412-904-3410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001741L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
100435OtherBLUE SHIELD
480021580OtherRAILROAD MEDICARE
102095OtherUPMC HEALTH PLAN
4021368OtherAETNA
PA000505630Medicaid
1034770OtherGATEWAY HEALTH PLAN
100435OtherBLUE SHIELD
480021580OtherRAILROAD MEDICARE
1034770OtherGATEWAY HEALTH PLAN