Healthcare Provider Details

I. General information

NPI: 1326733122
Provider Name (Legal Business Name): ELIZABETH MARIE OLAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2023
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35010 CHARDON RD STE 205
WILLOUGHBY HILLS OH
44094-9011
US

IV. Provider business mailing address

601 ELMWOOD AVE
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 440-571-0017
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.156141
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: