Provider Demographics
NPI:1003037060
Name:MAZZIA, LISA M (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:M
Last Name:MAZZIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:245 PARSONAGE RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2105
Mailing Address - Country:US
Mailing Address - Phone:732-632-8683
Mailing Address - Fax:732-632-8683
Practice Address - Street 1:245 PARSONAGE RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2105
Practice Address - Country:US
Practice Address - Phone:732-632-8683
Practice Address - Fax:732-632-8683
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY155624207VH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VH0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyHospice and Palliative Medicine