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General NPI Number Information
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NPI Number | 1043753908
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Entity Type | Individual
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Provider Name | NICHOLAS MAZZONE DPT
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Gender | Male
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Dates
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Enumeration Date | 11/28/2016
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Last Update Date | 12/06/2025
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Provider Practice Location Address
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Address Line | 140 CENTRAL AVE
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City | CLARK
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State | NJ
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Zip | 07066-1121
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Country | US
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Telephone | 732-943-5033
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Fax |
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Provider Business Mailing Address
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Address Line | 218 ELIZABETH AVE
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City | CRANFORD
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State | NJ
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Zip | 07016-2423
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Country | US
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Telephone | 718-216-6161
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 041101
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License Number State | NY
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