DR. NICHOLAS CONSTANTINE MAZANITIS


Address: 20 Westwood Drive, Worcester, MA 01609
Phone: 5087995783

DR. NICHOLAS CONSTANTINE MAZANITIS (NPI# 1932291184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932291184
Entity Type Individual
Full Name DR. NICHOLAS CONSTANTINE MAZANITIS
Credential M.D.
Practice Address 20 Westwood Drive
Worcester
MA 01609
Mailing Address 1182 Hope St
Bristol
RI 02809-1126
Practice Telephone 5087995783
Mailing Telephone 4017292359
Mailing Fax Number 4017292029
Enumeration Date 2006-09-28
Last Update Date 2015-09-15
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
55182 MA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MA 3033988 05

Office Location

Street Address 20 WESTWOOD DRIVE
City WORCESTER
State MA
Zip Code 01609

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NPI Name Taxonomy Address Enumeration
1669018388 Alyssa Lynne Szymkowicz Counselor 2b Pelham Street, Apartment 3, Worcester, MA 01609 2019-11-19
1295200848 Carmen P Rivera Martinez Counselor 20 Irving Street, Worcester, MA 01609 2018-10-10
1386126704 Sarah J Macdonald Psychologist 27 Sever St, Worcester, MA 01609 2018-09-01
1437641107 Christopher Quoc-duy Nguyen Dentist 111 Elm Street Suite 203, Worcester, MA 01609 2018-05-30
1396190096 Dasa Home Health Inc Home Health 255 Park Ave Ste 1101a, Worcester, MA 01609 2016-04-30
1912306135 Neighborhood Dental Group, PC Dentist 111 Elm St Suite 203, Worcester, MA 01609 2014-08-14
1306254875 Brenda Mccarthy-trayah Counselor 198 Russell St., Worcester, MA 01609 2014-07-29
1386052009 Allene Rizzolo Early Intervention Provider Agency 548 Park Ave., South Bay Early Intervention, Worcester, MA 01609 2014-07-25
1477849032 Diversified Staffing Nursing Care 39 Salisbury Street, Worcester, MA 01609 2011-06-22
1508195140 64 Highland Dental Dentist 64 Highland Street, Worcester, MA 01609 2009-12-10
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Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043508617 Kathryn R Wagner Radiology 10 Belvidere Ave, Worcester, MA 01605 2011-07-18
1922164755 Brian T Brochu Radiology U-mass Memorial Medical Center, 55 Lake Avenue North, Worcester, MA 01655 2006-12-28
1053359935 David M Rogovitz Radiology 55 Lake Av North, Umass Memorial Medical Center, Worcester, MA 01655 2006-06-03
1407894777 David A Phillips Radiology 55 Lake Ave North, Umass Memorial/radiology, Worcester, MA 01655 2006-06-02
1134175441 Abigail M Childs Radiology 100 Grove St, Worcester, MA 01605-2627 2006-05-26
1790743177 Patricia H Sutman Radiology 55 Lake Ave N., Umass Memorial, Worcester, MA 01605 2006-05-03
1477520930 Jorge M Medina Radiology 55 Lake Ave N # S2-824, Worcester, MA 01655-0002 2006-03-03
1578554044 Christine L Petersen Radiology 135 Gold Star Blvd, Worcester, MA 01606-2738 2005-11-02
1689197196 Nazanin Hajarol Asvadi Radiology 123 Summer St, Worcester, MA 01608 2017-07-18
1417305632 Vivek Pargaonkar Radiology 55 Lake Ave N, Worcester, MA 01655-0002 2016-05-27
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City WORCESTER
Zip Code 01609

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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