Healthcare Provider Details

I. General information

NPI: 1497867675
Provider Name (Legal Business Name): SANDRA SILVIA CUZZI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 FOREST GLEN RD
SILVER SPRING MD
20910-1483
US

IV. Provider business mailing address

9809 SINGLETON DR
BETHESDA MD
20817-2330
US

V. Phone/Fax

Practice location:
  • Phone: 301-754-7242
  • Fax: 301-754-7154
Mailing address:
  • Phone: 301-571-5129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0047159
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD20239
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: