Individual provider Active NPI

Nathaniel Mazza, D.C.

  • Sports Physician Chiropractor
  • Englishtown, NJ
National Provider Identifier
1154680239
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
X010739 Issued in NY
Practice address
12 Northgate Dr
Englishtown, NJ 07726-4258
Phone
(732) 446-4851
NPI assigned
May 10, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X X010739 NY Primary

Addresses

Primary practice location

12 Northgate Dr
Englishtown, NJ 07726-4258

Mailing address

12 Northgate Dr
Englishtown, NJ 07726-4258
Phone (732) 446-4851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
X010739NYMDSports Physician Chiropractor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1154680239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 NORTHGATE DR",
            "city": "ENGLISHTOWN",
            "state": "NJ",
            "postal_code": "077264258",
            "telephone_number": "732-446-4851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 NORTHGATE DR",
            "city": "ENGLISHTOWN",
            "state": "NJ",
            "postal_code": "077264258",
            "telephone_number": "732-446-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZA",
        "first_name": "NATHANIEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-10",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NY",
            "license": "X010739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englishtown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.