Provider Demographics
NPI:1043827389
Name:KRASNOV, SABINA
Entity type:Individual
Prefix:MRS
First Name:SABINA
Middle Name:
Last Name:KRASNOV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 N HAYDEN RD STE B112
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-2538
Mailing Address - Country:US
Mailing Address - Phone:480-767-3450
Mailing Address - Fax:
Practice Address - Street 1:8300 N HAYDEN RD STE B112
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-2538
Practice Address - Country:US
Practice Address - Phone:480-767-3450
Practice Address - Fax:480-535-5536
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ003160156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician