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Individual

MR. ROY KONRAD OLSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
453 BAY RIDGE PKWY, BROOKLYN, NY 11209-2701
(718) 833-0869
(718) 833-0869
Mailing address
453 BAY RIDGE PKWY, BROOKLYN, NY 11209-2701
(718) 833-0869
(718) 833-0869

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N005647
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02157519
NY
Enumeration date
01/23/2007
Last updated
09/01/2011
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