Provider Demographics
NPI:1770093064
Name:MAZZUCA, DANIELLE M (PA-C)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:M
Last Name:MAZZUCA
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:99 PASSMORE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-1548
Mailing Address - Country:US
Mailing Address - Phone:302-478-9411
Mailing Address - Fax:302-479-9883
Practice Address - Street 1:99 PASSMORE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-1548
Practice Address - Country:US
Practice Address - Phone:302-478-9411
Practice Address - Fax:302-479-9883
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2022-07-06
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant