Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Roman Mazurov

Individual provider Physical Therapy Assistant · NPI 1114630167

Roman Mazurov is a Physical Therapy Assistant in Lyndhurst, New Jersey. Practices as a sole proprietor. Licensed in New Jersey.

Licensed in
NJ
In the registry since
2023
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Practice location Address checks out

70 Ridge Rd
Lyndhurst, NJ 07071-1216
Phone: (201) 992-0183
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X (NJ)

Record details

NPI number1114630167
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 4, 2023
Last updated in NPPESJanuary 4, 2023
Certification dateJanuary 4, 2023
Mailing address576 Broadhollow Rd, Melville, NY 11747-5002

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