Alan Bruce Olmstead, RPA-C

Individual provider Active NPI Medical Physician Assistant · Selkirk, NY

NPI 1376678243 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1376678243
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
000724-1 (NY)
Practice address
1 Noryl Ave
Selkirk, NY 12158-9765
Phone
(518) 475-5033
Fax
(518) 475-5793
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
000724-1NYMDAudiologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 000724-1 NY Yes

Addresses

Primary practice location

1 Noryl Ave
Selkirk, NY 12158-9765

Mailing address

29 Ellsworth Ave
Delmar, NY 12054-1419
Phone (518) 475-5033

Other providers in Selkirk, NY

All providers in Selkirk, NY · Medical Physician Assistant in New York

Sources for this page

Verify at the official NPI Registry.