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General NPI Number Information
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NPI Number | 1275804973
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Entity Type | Individual
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Provider Name | OKSANA BOLSON N.P.
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Gender | Female
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Dates
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Enumeration Date | 01/26/2012
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Last Update Date | 01/26/2012
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Provider Practice Location Address
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Address Line | 430 BEACH 68TH ST
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City | ARVERNE
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State | NY
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Zip | 11692-1407
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Country | US
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Telephone | 718-474-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 2137 81ST ST
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City | BROOKLYN
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State | NY
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Zip | 11214-2507
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Country | US
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Telephone | 646-696-5717
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Fax | 646-696-5717
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F304473-1
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License Number State | NY
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