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General NPI Number Information
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NPI Number | 1053242420
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Entity Type | Individual
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Provider Name | JENNIFER MARIE MAZZA MD
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Gender | Female
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Dates
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Enumeration Date | 05/26/2026
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Last Update Date | 05/26/2026
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Provider Practice Location Address
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Address Line | 100 NEAL AVENUE
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City | MARION CENTER
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State | PA
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Zip | 15759
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Country | US
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Telephone | 724-397-5571
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Fax |
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Provider Business Mailing Address
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Address Line | 835 HOSPITAL RD
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City | INDIANA
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State | PA
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Zip | 15701-3629
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Country | US
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Telephone | 724-357-7000
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | MT236260
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License Number State | PA
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