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General NPI Number Information
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NPI Number | 1629540778
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Entity Type | Organization
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Legal Business Name | OLGA KHEYSON MD PC
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Dates
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Enumeration Date | 12/28/2018
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 3371 RICHMOND AVE STE 1
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City | STATEN ISLAND
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State | NY
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Zip | 10312-2025
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Country | US
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Telephone | 917-916-2457
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Fax |
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Provider Business Mailing Address
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Address Line | 9 MALLOW ST LOWR LEFT
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City | STATEN ISLAND
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State | NY
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Zip | 10309-1731
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Country | US
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Telephone | 929-203-9494
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Fax | 347-983-6126
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Authorized Official
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Title or Position | MD / PC OWNER
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Name | OLGA KHEYSON
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Credential | MD
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Telephone | 917-916-2457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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