Individual
DEAN OLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4422 3RD AVE, CARE OF EMERGENCY MEDICAL DEPARTMENT, BRONX, NY 10457-2545
(718) 960-6103
(718) 960-6125
Mailing address
2201 HEMPSTEAD TPKE, CARE OF EMERGENCY MEDICAL DEPARTMENT, EAST MEADOW, NY 11554-1859
(303) 859-9182
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
235895
NY
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
Primary
235895
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02691041
—
NY
Enumeration date
05/11/2006
Last updated
03/24/2014
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