Mazzacco, Stacey Louise

Mazzacco, Stacey Louise is an individual health care provider with primary practice located at 2104 Harrisburg Pike Ste 200, Lancaster PA 17601-2644. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is her primary health care specialty. Mazzacco, Stacey Louise can be contacted via phone (717) 544-3626.

Contact Information

Primary practice address
2104 Harrisburg Pike Ste 200 Lancaster PA 17601-2644
Phone: (717) 544-3626
Fax: (717) 544-3628
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD053932L Pennsylvania
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X MD053932L Pennsylvania

Profile Details

NPI number 1265413207
LBN Legal business name Mazzacco, Stacey Louise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2005
Last updated Sep 30th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1265413207 NPPES
Pennsylvania MEDICAID 0178844
Pennsylvania Other 020048899

Popular Providers