Provider Demographics
NPI:1609807940
Name:FIGLO, DAWN OLSEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:OLSEN
Last Name:FIGLO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 140036
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-0036
Mailing Address - Country:US
Mailing Address - Phone:718-477-5766
Mailing Address - Fax:718-477-0550
Practice Address - Street 1:2285 VICTORY BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6625
Practice Address - Country:US
Practice Address - Phone:718-477-5766
Practice Address - Fax:718-477-0550
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005691-1213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02264235Medicaid
NY4415690001Medicare NSC
NYP00137002Medicare ID - Type UnspecifiedRAILROAD
NY02264235Medicaid
NYU82795Medicare UPIN