Sortor, Jennifer Mazzola
Sortor, Jennifer Mazzola is an individual health care provider with primary practice located at 2433 Oak Valley Dr Suite 300, Ann Arbor MI 48103-7602. She recently has 5 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Sortor, Jennifer Mazzola can be contacted via phone (734) 994-0100.Contact Information
Primary practice address
2433 Oak Valley Dr Suite 300
Ann Arbor MI 48103-7602
Phone: (734) 994-0100
Fax: (734) 994-9625
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Optometrist | 152W00000X | 4901004033 | Michigan |
Eye and Vision Services Providers / Pediatrics | 152WP0200X | 4901004033 | Michigan |
Eye and Vision Services Providers / Sports Vision | 152WS0006X | 4901004033 | Michigan |
Eye and Vision Services Providers / Vision Therapy | 152WV0400X | 4901004033 | Michigan |
Eye and Vision Services Providers / Occupational Vision | 152WX0102X | 4901004033 | Michigan |
Profile Details
NPI number | 1578555884 |
---|---|
LBN Legal business name | Sortor, Jennifer Mazzola |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 22nd, 2005 |
Last updated | Nov 20th, 2007 - about 17 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1578555884 | NPPES |
Michigan | MEDICAID | 4175195 | |
Michigan | Other | JS004033 |
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