Kouznetsov, Diana I.
Kouznetsov, Diana I. is an individual health care provider with primary practice located at 55 Lake Ave N Department Of Anesthesiology, Worcester MA 01655-0002. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Kouznetsov, Diana I. can be contacted via phone (508) 334-3271.Contact Information
Primary practice address
55 Lake Ave N Department Of Anesthesiology
Worcester MA 01655-0002
Phone: (508) 334-3271
Fax: (508) 856-5911
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 216747 | Massachusetts |
Profile Details
| NPI number | 1558352492 |
|---|---|
| LBN Legal business name | Kouznetsov, Diana I. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 31st, 2005 |
| Last updated | Nov 3rd, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558352492 | NPPES |
| Massachusetts | MEDICAID | 2090911 |
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