Provider Demographics
NPI:1124070628
Name:HAZLETT, NANCY (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:HAZLETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 SHADY AVE
Mailing Address - Street 2:D107
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4409
Mailing Address - Country:US
Mailing Address - Phone:412-661-5644
Mailing Address - Fax:412-422-8807
Practice Address - Street 1:401 SHADY AVE
Practice Address - Street 2:D107
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4409
Practice Address - Country:US
Practice Address - Phone:412-661-5644
Practice Address - Fax:412-422-8807
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047935L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA776438Medicare ID - Type Unspecified