Provider Demographics
NPI:1841932464
Name:SAZONOVA, OLGA (MD)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:SAZONOVA
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 1:143, RUE WOLFE
Mailing Address - Street 2:
Mailing Address - City:LEVIS
Mailing Address - State:QUEBEC
Mailing Address - Zip Code:G6V 3Z1
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:143, RUE WOLFE
Practice Address - Street 2:
Practice Address - City:LEVIS
Practice Address - State:QUEBEC
Practice Address - Zip Code:G6V 3Z1
Practice Address - Country:CA
Practice Address - Phone:581-777-0790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ01986207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology