Provider Demographics
NPI:1811713787
Name:MAZER, MADELINE MAE
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:MAE
Last Name:MAZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13813 CALABOONE RD
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44230-9587
Mailing Address - Country:US
Mailing Address - Phone:330-760-9667
Mailing Address - Fax:
Practice Address - Street 1:13813 CALABOONE RD
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:OH
Practice Address - Zip Code:44230-9587
Practice Address - Country:US
Practice Address - Phone:330-760-9667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty