| Doctor Name: | REGINA MAZZUCA |
| NPI Number: | 1154404796 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN-C |
| License Number: | 26NJ008400 |
| Business Practice Address: | 524 Williamstown Rd Sicklerville, NJ - 080811824 |
| Business Phone Number: | 8567281181 |
| Business Fax Number: | 8567281182 |
| Mailing Address: | 302 Kains Ct, MARLTON |
| State: | NJ |
| Postal Code: | 080532947 |
| Phone Number: | 8565961950 |
| Fax Number: | |
| NPI Enumeration Date: | 10/24/2006 |
| NPI Last Update Date: | 10/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 26NJ008400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |