Provider Demographics
NPI:1265479786
Name:OLENDER, KATTIA (MD)
Entity Type:Individual
Prefix:MRS
First Name:KATTIA
Middle Name:
Last Name:OLENDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E 56TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3609
Mailing Address - Country:US
Mailing Address - Phone:212-421-6509
Mailing Address - Fax:212-421-6504
Practice Address - Street 1:160 E 56TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3609
Practice Address - Country:US
Practice Address - Phone:212-421-6509
Practice Address - Fax:212-421-6504
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214953-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02360896Medicaid
NY52C291Medicare ID - Type Unspecified
NY02360896Medicaid