Provider Demographics
NPI:1316203698
Name:OLZINSKI, MICHAEL (RPH, PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:OLZINSKI
Suffix:
Gender:M
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF CONNECTICUT
Mailing Address - Street 2:234 GLENBROOK ROAD UNIT 2011
Mailing Address - City:STORRS
Mailing Address - State:CT
Mailing Address - Zip Code:06269-2011
Mailing Address - Country:US
Mailing Address - Phone:860-486-3357
Mailing Address - Fax:860-486-0792
Practice Address - Street 1:UNIVERSITY OF CONNECTICUT
Practice Address - Street 2:234 GLENBROOK ROAD UNIT 2011
Practice Address - City:STORRS
Practice Address - State:CT
Practice Address - Zip Code:06269-2011
Practice Address - Country:US
Practice Address - Phone:860-486-3357
Practice Address - Fax:860-486-0792
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8253183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT8253OtherPHARMACIST