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General NPI Number Information
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NPI Number | 1649793142
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Entity Type | Organization
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Legal Business Name | OLYMPIA SERVICES INC
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Dates
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Enumeration Date | 07/18/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1913 OLYMPIA BLVD.
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City | STATEN ISLAND
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State | NY
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Zip | 10306
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Country | US
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Telephone | 917-709-5114
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Fax | 718-228-6339
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Provider Business Mailing Address
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Address Line | 1913 OLYMPIA BLVD.
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City | STATEN ISLAND
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State | NY
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Zip | 10306
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Country | US
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Telephone | 917-709-5114
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Fax | 718-228-6339
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEXEY KATNOV
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Credential |
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Telephone | 917-709-5114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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