MEDICARE: MRS. OLGA MILITSINA FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	358981	NY

General Provider Information

NPI Number	:	1780525436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. OLGA MILITSINA FNP

Provider Business Mailing Address
First Line	:	38 PAMELA LN
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-4437
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	38 PAMELA LN
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-4437
Country	:	US
Telephone Number	:	718-448-3800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2026
Last Update Date	:	04/04/2026

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