Provider Demographics
NPI:1184696957
Name:MAUZY, ERIK B (OD)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:B
Last Name:MAUZY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 LIGONIER ST
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-1882
Mailing Address - Country:US
Mailing Address - Phone:724-539-1671
Mailing Address - Fax:724-539-1654
Practice Address - Street 1:1010 LIGONIER ST
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1882
Practice Address - Country:US
Practice Address - Phone:724-539-1671
Practice Address - Fax:724-539-1654
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000414152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1009331570001Medicaid
PAP00433380OtherTRAVELERS MEDICARE
PA1009331570001Medicaid
U97977Medicare UPIN