Individual
OLGA PONOMAREVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
940 BELMONT ST, BROCKTON, MA 02301-5596
(508) 583-4500
Mailing address
701 W PRATT ST RM 474, BALTIMORE, MD 21201-1023
(410) 328-6325
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
284152
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2016
Last updated
09/09/2020
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