Provider Demographics
NPI:1306956446
Name:SOGOR, LASZLO (MD)
Entity type:Individual
Prefix:
First Name:LASZLO
Middle Name:
Last Name:SOGOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 LORAIN AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3721
Mailing Address - Country:US
Mailing Address - Phone:216-961-8804
Mailing Address - Fax:216-334-2211
Practice Address - Street 1:19550 ROCKSIDE RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-2083
Practice Address - Country:US
Practice Address - Phone:440-232-8381
Practice Address - Fax:440-232-9371
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.044396-S207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0487852Medicaid
OH0487852Medicaid
OHSO0524177Medicare ID - Type Unspecified