Individual
JAMES PATRICK OLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
7559 263RD ST, GLEN OAKS, NY 11004-1150
(718) 470-8763
Mailing address
2 ELLIE LN, SAINT JAMES, NY 11780-3053
(631) 525-9335
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
026249
NY
103T00000X
Psychologist
026249
NY
103TC0700X
Clinical Psychologist
026249
NY
Other
Enumeration date
12/28/2023
Last updated
12/28/2023
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