1427197136 NPI number — RICHARD MAZZAFERRO DO PC

Table of content: DR. CASH WAYNE LEWIS D.C. (NPI 1891925012)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427197136 NPI number — RICHARD MAZZAFERRO DO PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICHARD MAZZAFERRO DO PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427197136
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 86
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HINGHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02043-0086
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-749-9071
Provider Business Mailing Address Fax Number:
781-749-2133

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 CONGRESS ST
Provider Second Line Business Practice Location Address:
SUITE 304
Provider Business Practice Location Address City Name:
QUINCY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02169-0907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-773-6300
Provider Business Practice Location Address Fax Number:
617-773-6301
Provider Enumeration Date:
02/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MAZZAFERRO
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
V
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
617-773-6300

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  204521 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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