Individual
OLGA TKACHENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
224 HAMBURG TPKE, WAYNE, NJ 07470-2168
(973) 942-6900
Mailing address
3545 79TH ST APT 5E, JACKSON HEIGHTS, NY 11372-4836
(347) 350-4934
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26NJ01293100
NJ
367500000X
Certified Registered Nurse Anesthetist
622678
NY
Other
Enumeration date
06/12/2019
Last updated
08/13/2024
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