Healthcare Provider Details

I. General information

NPI: 1841104114
Provider Name (Legal Business Name): CAITLIN OLSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14230 BARCLAY AVE
FLUSHING NY
11355-2558
US

IV. Provider business mailing address

8111 161ST AVE
HOWARD BEACH NY
11414-2944
US

V. Phone/Fax

Practice location:
  • Phone: 718-359-0321
  • Fax:
Mailing address:
  • Phone: 347-287-5403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number036984
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: