Provider Demographics
NPI:1144083270
Name:MAZZONE, CONCETTA CATERINA
Entity type:Individual
Prefix:
First Name:CONCETTA
Middle Name:CATERINA
Last Name:MAZZONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6236 LEDGEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38135-2410
Mailing Address - Country:US
Mailing Address - Phone:901-601-5738
Mailing Address - Fax:
Practice Address - Street 1:6236 LEDGEWOOD LN
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38135-2410
Practice Address - Country:US
Practice Address - Phone:901-601-5738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program