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General NPI Number Information
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NPI Number | 1932435468
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Entity Type | Organization
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Legal Business Name | PHYLLIS OLSHANSKY INC
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Dates
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Enumeration Date | 10/17/2009
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Last Update Date | 10/17/2009
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Provider Practice Location Address
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Address Line | 60 LAKEVIEW RD
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City | NEW ROCHELLE
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State | NY
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Zip | 10804-2506
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Country | US
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Telephone | 914-636-8051
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Fax | 914-636-6957
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Provider Business Mailing Address
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Address Line | 60 LAKEVIEW RD
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City | NEW ROCHELLE
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State | NY
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Zip | 10804-2506
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Country | US
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Telephone | 914-636-8051
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Fax | 914-636-6957
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHYLLIS MACKLIN OLSHANSKY
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Credential | PHD
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Telephone | 914-636-8051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 4079
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License Number State |
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