Provider Demographics
NPI:1174664320
Name:ZAKHAROV, VLADISLAV (MD)
Entity Type:Individual
Prefix:
First Name:VLADISLAV
Middle Name:
Last Name:ZAKHAROV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 YORK ST # EP2-607
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3220
Mailing Address - Country:US
Mailing Address - Phone:877-925-3522
Mailing Address - Fax:
Practice Address - Street 1:20 YORK ST # EP2-607
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:877-925-3522
Practice Address - Fax:203-737-5388
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2023-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT54082207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology