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General NPI Number Information
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NPI Number | 1902218829
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Entity Type | Individual
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Provider Name | SANDRA MAZZONI D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2014
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Last Update Date | 08/01/2020
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVENUE
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City | CLEVELAND
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State | OH
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Zip | 44193-7021
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Country | US
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Telephone | 216-445-2025
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Fax |
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Provider Business Mailing Address
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Address Line | 9500 EUCLID AVENUE
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City | CLEVELAND
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State | OH
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Zip | 44193-1913
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Country | US
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Telephone | 216-445-2025
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 34.014609
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5101020994
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License Number State | MI
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