Samantha Mazzucco, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12230PT Issued in AZ

Practice address

2560 E Fort Lowell Rd
Tucson, AZ 85716-1514

Phone

(520) 323-9086

Fax

(520) 323-6364

NPI assigned

Jun 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Andazola Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1700236262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 WALNUT ST",
            "address_2": "SUITE 110",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012416",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 E FORT LOWELL RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857161514",
            "telephone_number": "520-323-9086",
            "fax_number": "520-323-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZUCCO",
        "first_name": "SAMANTHA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "12230PT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "ANDAZOLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Patricia Mazzarella, M.S, PH.D
• David J Mazzola Jr., SA-C
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• Fredrick Mbinga, PTA
• Teri Marie MC Clemons, EDS

• Physical Therapist in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; 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.