Provider Demographics
NPI:1285816223
Name:AGARKOV, OLGA (LPN)
Entity Type:Individual
Prefix:MS
First Name:OLGA
Middle Name:
Last Name:AGARKOV
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:OLGA
Other - Middle Name:
Other - Last Name:DROBOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:25 W MAIN ST
Mailing Address - Street 2:PO 879
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13365-9998
Mailing Address - Country:US
Mailing Address - Phone:315-868-3699
Mailing Address - Fax:
Practice Address - Street 1:25 W MAIN ST
Practice Address - Street 2:PO 879
Practice Address - City:LITTLE FALLS
Practice Address - State:NY
Practice Address - Zip Code:13365-9998
Practice Address - Country:US
Practice Address - Phone:315-868-3699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-01
Last Update Date:2007-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161845-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse