Provider Demographics
NPI:1205281573
Name:MEZZAPELLI, JAMES (LAC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MEZZAPELLI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 WASHINGTON ST SUITE 2B1
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07641-3216
Mailing Address - Country:US
Mailing Address - Phone:201-627-8300
Mailing Address - Fax:201-627-8301
Practice Address - Street 1:32 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-3216
Practice Address - Country:US
Practice Address - Phone:201-627-8300
Practice Address - Fax:201-627-8301
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00117300171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist