Individual
EVGENY OLENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10537 64TH AVE, FOREST HILLS, NY 11375-1645
(718) 459-0111
(718) 896-1596
Mailing address
105-37 64 AVENUE, FOREST HILLS, NY 11375-1645
(718) 459-0111
(718) 896-1596
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
145218
NY
207ZP0101X
Anatomic Pathology Physician
145218
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00736250
—
NY
Enumeration date
10/31/2006
Last updated
07/29/2008
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