Individual
DR. ELEANOR J OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4546 HYLAN BLVD, STATEN ISLAND, NY 10312-6400
(718) 948-5111
(718) 948-1932
Mailing address
3718 BAYVIEW AVE, BROOKLYN, NY 11224-1602
(718) 266-0576
(718) 948-1932
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
038722-2
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00847810
—
NY
Enumeration date
08/09/2006
Last updated
07/08/2007
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