Physician Compare National (NPI:1871930701)

HEALTHCARE PROVIDER: ADELIA SAZONOV D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1871930701
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3678843885
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170720002598
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SAZONOV
	Individual professional last name
Provider First Name	ADELIA
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
	Individual professional's medical school
Graduation Year	1993
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	NEUROPSYCHIATRY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	NEUROPSYCHIATRY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	COUNTY OF CHAUTAUQUA - A MUN CORP
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1951380633
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	16
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	319 CENTRAL AVE
	Group Practice or individual's line 1 address
City	DUNKIRK
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	140482137
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7163633550
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y