Healthcare Provider Details

I. General information

NPI: 1952830010
Provider Name (Legal Business Name): JULIE OLNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2017
Last Update Date: 06/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6459 KARLEN RD
ROME NY
13440-7451
US

IV. Provider business mailing address

6459 KARLEN ROAD
ROME NY
13440
US

V. Phone/Fax

Practice location:
  • Phone: 315-225-8315
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: