Provider Demographics
NPI:1023901238
Name:MAZZAFERRO, HOLLY
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:MAZZAFERRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 HILSON DR
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-0801
Mailing Address - Country:US
Mailing Address - Phone:315-338-3771
Mailing Address - Fax:
Practice Address - Street 1:409 BELL RD S
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-5298
Practice Address - Country:US
Practice Address - Phone:315-334-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY736495163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool