Dominic Mazza, D.C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00553500 Issued in NJ

Practice address

36 Lydia Dr
Guttenberg, NJ 07093-8366

Phone

(201) 317-6104

Fax

(201) 868-0874

NPI assigned

Dec 8, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brooklyn Motion Chiropractic PC

  • Rehabilitation Clinic/Center
  • Brooklyn, NY
  • NPI 1750221776
  NPD Authorized official
• Maplewood Chiropractic PC

  • Chiropractor
  • Guttenberg, NJ
  • NPI 1962819607
  NPD (past) Authorized official

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1659516466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 LYDIA DR",
            "city": "GUTTENBERG",
            "state": "NJ",
            "postal_code": "070938366",
            "telephone_number": "201-317-6104",
            "fax_number": "201-868-0874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 LYDIA DR",
            "city": "GUTTENBERG",
            "state": "NJ",
            "postal_code": "070938366",
            "telephone_number": "201-317-6104",
            "fax_number": "201-868-0874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZA",
        "first_name": "DOMINIC",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-08",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00553500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ LICENSE NUMBER",
            "identifier": "38MC00553500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Conzuelo Leiva, LAC
• Yilliam Lopez del Bosque, NP-C
• Terrylee Maimone, O.D.
• Manoj Malhotra, MD
• Maplewood Chiropractic PC
• McAreh Medical P.C.
• Parviz Moazami, M.D.
• Nabeel M Najib, MD
• Stephanie No, APRN, FNP-C
• Roberto Carlos Novella

• Chiropractor in Guttenberg, NJ
• Providers in Guttenberg, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; 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.