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General NPI Number Information
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NPI Number | 1871684860
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Entity Type | Organization
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Legal Business Name | AIRPORT MEDICAL OFFICES AT JFK
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 23059 INT'L AIRPORT CENTER BLVD SUITE 225
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City | JAMAICA
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State | NY
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Zip | 11413-1644
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Country | US
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Telephone | 718-244-1644
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Fax | 718-244-1622
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Provider Business Mailing Address
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Address Line | 23059 INT'L AIRPORT CENTER BLVD SUITE 225
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City | JAMAICA
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State | NY
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Zip | 11413
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Country | US
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Telephone | 718-244-1644
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Fax | 718-244-1622
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | OLEG OLSHANETSKIY
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Credential | DO
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Telephone | 718-244-1644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 215014-1
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License Number State | NY
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