Individual provider Active NPI

Wanda Theresa Mazzamurro, D.C.

  • Chiropractor
  • Westborough, MA
National Provider Identifier
1750435095
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1421 Issued in MA
Practice address
108 Milk St
Suite 1
Westborough, MA 01581-1228
Phone
(508) 366-7733
Fax
(508) 366-3334
NPI assigned
Jan 23, 2007
Last updated
Jun 18, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1421 MA Primary

Addresses

Primary practice location

108 Milk St
Suite 1
Westborough, MA 01581-1228

Mailing address

108 Milk St
Suite 1
Westborough, MA 01581-1228
Phone (508) 366-7733

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1421MAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1750435095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 MILK ST",
            "address_2": "SUITE 1",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015811228",
            "telephone_number": "508-366-7733",
            "fax_number": "508-366-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 MILK ST",
            "address_2": "SUITE 1",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015811228",
            "telephone_number": "508-366-7733",
            "fax_number": "508-366-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZAMURRO",
        "first_name": "WANDA",
        "middle_name": "THERESA",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "1421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.