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General NPI Number Information
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NPI Number | 1669511911
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Entity Type | Individual
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Provider Name | ALISON QUEEN OLSEN P.A.
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 195 MCGREGOR ST SUITE312
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City | MANCHESTER
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State | NH
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Zip | 03102-3748
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Country | US
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Telephone | 603-663-8727
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Fax | 603-663-7376
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Provider Business Mailing Address
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Address Line | 390 PRINCETON AVE
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City | JERSEY CITY
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State | NJ
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Zip | 07305-4733
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Country | US
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Telephone | 603-663-8727
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Fax | 603-663-7376
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 010649-1
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License Number State | NY
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