Healthcare Provider Details

I. General information

NPI: 1144638032
Provider Name (Legal Business Name): OLGA KHINCH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2014
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 RIVERSIDE DR ROOM G612
BINGHAMTON NY
13905-4246
US

IV. Provider business mailing address

27 JENNISON AVE
JOHNSON CITY NY
13790-2302
US

V. Phone/Fax

Practice location:
  • Phone: 607-798-5132
  • Fax:
Mailing address:
  • Phone: 607-798-5432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number338942
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number338942
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: