Healthcare Provider Details

I. General information

NPI: 1568463743
Provider Name (Legal Business Name): WILLIAM B. OLNEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 08/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 PHILA ST APT #1
SARATOGA SPRINGS NY
12866-3322
US

IV. Provider business mailing address

112 PHILA ST APT #1
SARATOGA SPRINGS NY
12866-3322
US

V. Phone/Fax

Practice location:
  • Phone: 518-396-7598
  • Fax:
Mailing address:
  • Phone: 518-396-7598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number234841
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: