Olga Goulko, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MA065361 Issued in NJ

Practice address

2125 Center Ave Ste 200
Fort Lee, NJ 07024-5810

Phone

(201) 461-5655

Fax

(201) 461-1181

NPI assigned

Aug 25, 2006

Last updated

Jul 8, 2007By 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

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dermatology & Laser Surgery Ctr

  • Dermatology Physician
  • Fort Lee, NJ
  • NPI 1780937045
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710094578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 CENTER AVE STE 200",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245810",
            "telephone_number": "201-461-5655",
            "fax_number": "201-461-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 CENTER AVE STE 200",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245810",
            "telephone_number": "201-461-5655",
            "fax_number": "201-461-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULKO",
        "first_name": "OLGA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "MA065361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Golub, DMD
• Ilse M Gomez-Avila, LCSW
• Christian R Gongob, PHARMD
• Good Align Foot and Ankle LLC
• Good Care Dental PC
• Great Atlantic & Pacific Tea Company Inc (A & P Pharmacy)
• Growing Minds ABA LLC
• Daniela Gurpegui Abud, DDS, MS
• Sharon A Gutman, PHD, OTR/L
• Marissa Gynn, BCBA

• Dermatology Physician in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Dermatology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.