Healthcare Provider Details

I. General information

NPI: 1851308704
Provider Name (Legal Business Name): JAY A. MAZEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 06/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 IRVING ST NW STE 4800N
WASHINGTON DC
20010
US

IV. Provider business mailing address

106 IRVING ST NW STE 4800N
WASHINGTON DC
20010-2927
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-5800
  • Fax: 202-877-5885
Mailing address:
  • Phone: 202-877-5800
  • Fax: 202-877-5885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD32316
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: