Healthcare Provider Details

I. General information

NPI: 1700101839
Provider Name (Legal Business Name): OLGA DOLGOVA CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2010
Last Update Date: 02/18/2020
Certification Date: 02/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD
CLEVELAND OH
44106-1702
US

IV. Provider business mailing address

1881 PLEASEANT VALLEY ROAD
STREETSBORO OH
44241
US

V. Phone/Fax

Practice location:
  • Phone: 216-246-9898
  • Fax: 216-229-2554
Mailing address:
  • Phone: 216-246-9898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAPRN.CNP11814
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: