Provider Demographics
NPI:1225230121
Name:SANDRA V HAZRA MD INC
Entity Type:Organization
Organization Name:SANDRA V HAZRA MD INC
Other - Org Name:ADVANCED HEMATOLOGY ONCOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:V
Authorized Official - Last Name:HAZRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-762-5046
Mailing Address - Street 1:157 W CEDAR ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307-2564
Mailing Address - Country:US
Mailing Address - Phone:330-762-5046
Mailing Address - Fax:330-762-6797
Practice Address - Street 1:157 W CEDAR ST
Practice Address - Street 2:SUITE 215
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2564
Practice Address - Country:US
Practice Address - Phone:330-762-5046
Practice Address - Fax:330-762-6797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-03
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9229781Medicare PIN