Individual
MRS. CAROLLYN MARCELLA OLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
221 BROADWAY, STATEN ISLAND, NY 10310-1337
(718) 720-9087
(718) 720-9087
Mailing address
221 BROADWAY, STATEN ISLAND, NY 10310-1337
(718) 720-9087
(718) 720-9087
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
231803
NY
Other
Enumeration date
03/13/2012
Last updated
03/13/2012
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