Healthcare Provider Details

I. General information

NPI: 1063867596
Provider Name (Legal Business Name): OLGA GUZOVSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2016
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE UNIVERSITY HOSPITALS CASE MEDICAL CENTER
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

11100 EUCLID AVE UNIVERSITY HOSPITALS CASE MEDICAL CENTER
CLEVELAND OH
44106-1716
US

V. Phone/Fax

Practice location:
  • Phone: 440-520-3544
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.136273
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: