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General NPI Number Information
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NPI Number | 1497157572
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Entity Type | Individual
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Provider Name | GLORIA MARY MAZZA NP-C
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Gender | Female
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Dates
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Enumeration Date | 09/21/2014
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 111 HOWARD AVE BOX 8269
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City | CRANSTON
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State | RI
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Zip | 02920-3001
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Country | US
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Telephone | 401-447-1777
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Fax |
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Provider Business Mailing Address
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Address Line | 35 S COUNTY COMMONS WAY STE D11
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City | WAKEFIELD
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State | RI
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Zip | 02879-8252
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Country | US
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Telephone | 401-447-1777
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Fax | 401-205-3016
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN02129
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NPP37899
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License Number State | RI
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