Olga Ivanova, PPD, CLC

Primary specialty

DoulaTaxonomy code 374J00000X

Practice address

22410 67TH Ave
Bayside, NY 11364-2310

Phone

(646) 549-2545

NPI assigned

Mar 30, 2013

Last updated

Mar 30, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364601600000",
    "number": "1528301389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22410 67TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113642310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22410 67TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113642310",
            "telephone_number": "646-549-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANOVA",
        "first_name": "OLGA",
        "credential": "PPD, CLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-30",
        "last_updated": "2013-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Doula in Bayside, NY
• Providers in Bayside, NY by specialty
• Doula in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.