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NPI Code Detail

MEDICARE: FERMINA M MAZZELLA MD

MEDICARE: FERMINA M MAZZELLA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician25MA08151200NJ
2207ZH0000XHematology (Pathology) Physician25MA08151200NJ

General Provider Information

NPI Number : 1275522344
Entity Type Code : Individual
Provider Name (Legal Business Name) : FERMINA M MAZZELLA MD
Provider Business Mailing Address
First Line : 185 S ORANGE AVE
Second Line : ROOM C-579 - MSB
City : NEWARK
State : NJ
Zip : 07103-2757
Country : US
Telephone Number : 973-972-4520
Fax Number : 973-972-5909
Provider Business Practice Location Address
First Line : 150 BERGEN ST
Second Line : ROOM C-102
City : NEWARK
State : NJ
Zip : 07103-2496
Country : US
Telephone Number : 973-972-4619
Fax Number : 973-972-3199
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 09/11/2025

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Directions to “ FERMINA M MAZZELLA MD” Practice Location

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