Organization Active NPI

Dellorso, Goutos, Olshanetskiy, Physicians Laguardia, PLLC

Doing business as Airport Medical Offices at LGA

  • Family Medicine Physician
  • Flushing, NY
National Provider Identifier
1740293786
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DELLORSO, GOUTOS, OLSHANETSKIY, PHYSICIANS LAGUARDIA, PLLC
Doing business as
Airport Medical Offices at LGA
Practice address
Laguardia Airport Central Term BLDG
Suite 3771
Flushing, NY 11371
Phone
(718) 424-8663
Fax
(712) 424-8664
NPI assigned
Aug 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Oleg Olshanetskiy, DO
Title
Medical Director
Phone
(712) 244-1644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

Laguardia Airport Central Term BLDG
Suite 3771
Flushing, NY 11371

Mailing address

Laguardia Airport Central Terminal BLDG
Suite 3771
Flushing, NY 11371
Phone (718) 424-8663

Other names 1

  • Airport Medical Offices at LGA Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740293786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LAGUARDIA AIRPORT CENTRAL TERMINAL BLDG",
            "address_2": "SUITE 3771",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11371",
            "telephone_number": "718-424-8663",
            "fax_number": "712-424-8664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LAGUARDIA AIRPORT CENTRAL TERM BLDG",
            "address_2": "SUITE 3771",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11371",
            "telephone_number": "718-424-8663",
            "fax_number": "712-424-8664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELLORSO, GOUTOS, OLSHANETSKIY, PHYSICIANS LAGUARDIA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLSHANETSKIY",
        "authorized_official_first_name": "OLEG",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "712-244-1644",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Airport Medical Offices at LGA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.