SEBASTIAN A MAZZOTTA PC (NPI# 1932402781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932402781 |
| Entity Type | Organization |
| Organization Name | SEBASTIAN A MAZZOTTA PC |
| Practice Address |
4 Stillman Dr Canton NY 13617-1221 |
| Practice Telephone | 3153868141 |
| Practice Fax Number | 3153868493 |
| Mailing Telephone | 3153868141 |
| Mailing Fax Number | 3153868493 |
| Enumeration Date | 2010-12-17 |
| Last Update Date | 2015-07-09 |
| Authorized Official Name | MRS. CHRISTINE ANNE LAQUIER (OFFICE MANAGER) |
| Authorized Official Telephone | 3153868141 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
130060 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00630699 | 05 |
| Street Address |
4 STILLMAN DR |
| City | CANTON |
| State | NY |
| Zip Code | 13617-1221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013917624 | Sebastian Angelo Mazzotta | Internal Medicine | 4 Stillman Dr, Canton, NY 13617-1221 | 2005-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700428802 | Meagan Elizabeth Hogan | Physician Assistant | 6119 Us Highway Route 11, Canton, NY 13617 | 2019-10-10 |
| 1982251740 | Wilma J. Blackmer | Technician | 1756 Cr 14, Canton, NY 13617 | 2019-08-26 |
| 1326525270 | Kylie Broughal | Physician Assistant | 6119 St Hwy Rt 11, St Lawrence Medical Office Complex, Canton, NY 13617 | 2018-07-24 |
| 1891299608 | Sheena Teresa Smith | Counselor | 310 State Highway 310, Suite 1, Canton, NY 13617 | 2018-03-19 |
| 1972024594 | Patrick James Sullivan | Physician Assistant | 6619 State Highway Route 11, Canton, NY 13617 | 2017-07-05 |
| 1225482763 | Howard Orthotics and Prosthetics, LLC | Prosthetic/Orthotic Supplier | 6128 Us Highway11, Canton, NY 13617 | 2016-04-21 |
| 1831534452 | Chin Hung Ho | Dermatology | 6119 State Highway Rt 11, Cph Dermotology, Canton, NY 13617 | 2013-05-09 |
| 1194061663 | Sarah Prairie | Counselor | 80 State Hwy 310, Suite 1, Canton, NY 13617 | 2013-01-02 |
| 1679859094 | Nathan Ellis | Occupational Therapist | 139 Outer State St. Rd, Canton, NY 13617 | 2011-10-31 |
| 1407139017 | Julianne Rutley | Occupational Therapist | 139 Outer State Street Rd, Canton, NY 13617 | 2011-09-21 |
| Find all providers in zip 13617 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639223308 | Sanjiv Khetarpal | Internal Medicine | 4665 Belpar St Nw, Canton, OH 44718 | 2007-01-22 |
| 1326064254 | Edward Thomas Schirack | Internal Medicine | 3722 Dressler Road Nw, Canton, OH 44718 | 2006-07-14 |
| 1326027376 | Khalil B Korkor | Internal Medicine | 4124 Munson St Nw, Suite A, Canton, OH 44718-2979 | 2006-01-10 |
| 1821070830 | Karim Gani | Internal Medicine | 145 Riverstone Ter, Suite 100, Canton, GA 30114-5317 | 2005-11-16 |
| 1013917624 | Sebastian Angelo Mazzotta | Internal Medicine | 4 Stillman Dr, Canton, NY 13617-1221 | 2005-07-26 |
| 1093710055 | Kenny S Yung | Internal Medicine | 2726 Fulton Dr Nw, Canton, OH 44718-3506 | 2005-06-16 |
| 1497750822 | Nabil Fahmy | Internal Medicine | 4360 Fulton Dr Nw, Ste B, Canton, OH 44718-2824 | 2005-06-14 |
| 1245740661 | Ellen Lintner | Internal Medicine | 3722 Dressler Rd Nw, Canton, OH 44718-2700 | 2017-10-11 |
| 1639617608 | Gsi Canton LLC | Internal Medicine | 2726 Fulton Dr Nw, Canton, OH 44718-3506 | 2017-02-09 |
| 1972891737 | Amareshwar Podugu | Internal Medicine | 2726 Fulton Dr Nw, Canton, OH 44718-3506 | 2011-07-14 |
| Find all providers in CANTON | ||||
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| 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.