Dr. Robert Mazza,DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00169700 Issued in NJ

Legal business name

DR. ROBERT MAZZA,DC

Practice address

854 W Side Ave
Jersey City, NJ 07306-6514

Phone

(201) 432-8531

Fax

(201) 432-3404

NPI assigned

Jan 14, 2008

Last updated

Jan 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert Mazza, DC

Title

President

Phone

(201) 432-8531

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1396921912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 W SIDE AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073066514",
            "telephone_number": "201-432-8531",
            "fax_number": "201-432-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 W SIDE AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073066514",
            "telephone_number": "201-432-8531",
            "fax_number": "201-432-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. ROBERT MAZZA,DC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "MAZZA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-432-8531",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00169700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1182803",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.