MEDICARE: BRITTA KAREEN MAZUR DO

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
1	2080A0000X	Pediatric Adolescent Medicine Physician	188094-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770805921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTA KAREEN MAZUR DO

Provider Business Mailing Address
First Line	:	2171 JERICHO TPKE STE 342
Second Line	:
City	:	COMMACK
State	:	NY
Zip	:	11725-2900
Country	:	US
Telephone Number	:	631-499-3588
Fax Number	:	631-499-3583

Provider Business Practice Location Address
First Line	:	2171 JERICHO TPKE STE 342
Second Line	:
City	:	COMMACK
State	:	NY
Zip	:	11725-2900
Country	:	US
Telephone Number	:	631-499-3588
Fax Number	:	631-499-3583

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2010
Last Update Date	:	02/15/2010

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Directions to “ BRITTA KAREEN MAZUR DO” Practice Location

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