Provider Demographics
NPI:1295717114
Name:ZORN, MELISSA MAZZINI (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MAZZINI
Last Name:ZORN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:MAZZINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 760
Mailing Address - Street 2:WOBURN MEDICAL ASSOCIATES PC
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-4260
Mailing Address - Country:US
Mailing Address - Phone:781-756-7273
Mailing Address - Fax:781-721-0725
Practice Address - Street 1:500 SALEM ST
Practice Address - Street 2:WOBURN MEDICAL ASSOCIATES PC
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-1200
Practice Address - Country:US
Practice Address - Phone:978-988-9255
Practice Address - Fax:978-694-9675
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213171207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
213171OtherTUFTS
MA0176061Medicaid
J25373OtherBCBS
A34119Medicare ID - Type Unspecified
J25373OtherBCBS