Provider Demographics
NPI:1962637702
Name:MOLCHANOVA-COOK, OLGA PAVLOVNA (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:PAVLOVNA
Last Name:MOLCHANOVA-COOK
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:OLHA
Other - Middle Name:PAVLIVNA
Other - Last Name:MOLCHANOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-1609
Mailing Address - Country:US
Mailing Address - Phone:505-310-9489
Mailing Address - Fax:505-310-9489
Practice Address - Street 1:1415 TULANE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2600
Practice Address - Country:US
Practice Address - Phone:505-310-9489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-22
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.2061682085N0904X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology