MEDICARE: OLGA BAGRIY

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1952929770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLGA BAGRIY

Provider Business Mailing Address
First Line	:	2955 BRIGHTON 4TH ST STE 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-8541
Country	:	US
Telephone Number	:	718-332-0080
Fax Number	:	718-332-3365

Provider Business Practice Location Address
First Line	:	2435 OCEAN AVE APT 4E
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3538
Country	:	US
Telephone Number	:	917-331-2351
Fax Number	:

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

Provider Enumeration Date	:	07/08/2020
Last Update Date	:	07/08/2020

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Directions to “ OLGA BAGRIY ” Practice Location

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