Provider Demographics
NPI:1548583701
Name:OLSON, KRISTIN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 SARATOGA RD
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12302-4503
Mailing Address - Country:US
Mailing Address - Phone:518-399-6351
Mailing Address - Fax:
Practice Address - Street 1:259 SARATOGA RD
Practice Address - Street 2:
Practice Address - City:GLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12302-4503
Practice Address - Country:US
Practice Address - Phone:518-399-6351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049702-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist