Healthcare Provider Details

I. General information

NPI: 1295518421
Provider Name (Legal Business Name): SAFIYE BAHAR OLMEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E 210TH ST
BRONX NY
10467-2401
US

IV. Provider business mailing address

22 FAIRVIEW AVE
TUCKAHOE NY
10707-4143
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-5488
  • Fax:
Mailing address:
  • Phone: 347-295-9904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number111111111
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: