Provider Demographics
NPI:1568801314
Name:SANZONE, KAITLIN MARIA (MD)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:MARIA
Last Name:SANZONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 FARROW RD
Mailing Address - Street 2:BRYAN PSYCHIATRIC HOSPITAL- FORENSIC
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:803-935-0505
Mailing Address - Fax:
Practice Address - Street 1:7901 FARROW RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-3220
Practice Address - Country:US
Practice Address - Phone:803-935-6586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC358342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry