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General NPI Number Information
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NPI Number | 1780873968
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Entity Type | Organization
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Legal Business Name | LAUREN M MOZDY MD
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 3233 W 26TH ST
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City | ERIE
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State | PA
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Zip | 16506-2507
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Country | US
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Telephone | 814-833-1756
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Fax | 814-833-1671
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Provider Business Mailing Address
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Address Line | 3233 W 26TH ST
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City | ERIE
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State | PA
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Zip | 16506-2507
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Country | US
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Telephone | 814-833-1756
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Fax | 814-833-1671
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAUREN M MOZDY
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Credential | MD
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Telephone | 814-833-1756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | MD057038L
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License Number State | PA
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