Healthcare Provider Details

I. General information

NPI: 1467436915
Provider Name (Legal Business Name): ADAM JAN OLSZEWSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

150 UNION ST APT 617
PROVIDENCE RI
02903-1796
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-5435
  • Fax: 401-444-8918
Mailing address:
  • Phone: 401-429-3151
  • Fax: 401-633-6550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD11974
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: