Healthcare Provider Details

I. General information

NPI: 1437013687
Provider Name (Legal Business Name): NICHOLAS JOSEPH OLANO RD, CDN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 POMONA RD
SUFFERN NY
10901-1924
US

IV. Provider business mailing address

86 POMONA RD
SUFFERN NY
10901-1924
US

V. Phone/Fax

Practice location:
  • Phone: 845-893-3550
  • Fax:
Mailing address:
  • Phone: 845-893-3550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number011677
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: