Individual provider · Type 1 NPI

Stephanie Ellaine Vicencio Mazo, MD

Student in an Organized Health Care Education/Training Program · Middletown, NY

NPI number 1619662400 Active

Practice location

707 E Main St
Middletown, NY 10940-2650

Call (845) 333-7373 Map

Fax (845) 333-7342

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1619662400

Stephanie Ellaine Vicencio Mazo, MD's National Provider Identifier is 1619662400, issued on Apr 7, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Middletown, NY. The record was last updated on Apr 7, 2023.