Healthcare Provider Details

I. General information

NPI: 1891832697
Provider Name (Legal Business Name): JOANNE MAZZIO C.N.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1978 CROMPOND RD
CORTLANDT MANOR NY
10567-4111
US

IV. Provider business mailing address

50 DAYTON LANE, SUITE 202 THE WESTCHESTER MEDICAL PRACTICE PC
PEEKSKILL NY
10566
US

V. Phone/Fax

Practice location:
  • Phone: 914-736-6180
  • Fax: 914-736-6183
Mailing address:
  • Phone: 914-739-0087
  • Fax: 914-737-1714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0002X
TaxonomyHigh-Risk Obstetric Registered Nurse
License Number486404-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF000163-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: