MEDICARE: PETER MAZYK DPT

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	225100000X	Physical Therapist	40QA01054900	NJ

General Provider Information

NPI Number	:	1982673125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER MAZYK DPT

Provider Business Mailing Address
First Line	:	321 SHORE RD
Second Line	:
City	:	SOMERS POINT
State	:	NJ
Zip	:	08244-2600
Country	:	US
Telephone Number	:	609-927-4011
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 SHORE RD
Second Line	:
City	:	SOMERS POINT
State	:	NJ
Zip	:	08244-2600
Country	:	US
Telephone Number	:	609-927-4011
Fax Number	:	609-927-4019

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

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	03/18/2026

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