Provider Demographics
NPI:1376921874
Name:OLASIN, GEORGINA (RN)
Entity Type:Individual
Prefix:
First Name:GEORGINA
Middle Name:
Last Name:OLASIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 VILLAGE GRN APT J
Mailing Address - Street 2:
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-1304
Mailing Address - Country:US
Mailing Address - Phone:862-324-5696
Mailing Address - Fax:
Practice Address - Street 1:580 BROADWAY
Practice Address - Street 2:SUITE 608
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3223
Practice Address - Country:US
Practice Address - Phone:888-571-8629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY672585-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse