Provider Demographics
NPI:1649395252
Name:OLEINICK-GOLDSTEIN, MARCIE (OD)
Entity Type:Individual
Prefix:DR
First Name:MARCIE
Middle Name:
Last Name:OLEINICK-GOLDSTEIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35000 WARREN RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-6223
Mailing Address - Country:US
Mailing Address - Phone:734-261-0930
Mailing Address - Fax:734-261-0985
Practice Address - Street 1:35000 WARREN RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-6223
Practice Address - Country:US
Practice Address - Phone:734-261-0930
Practice Address - Fax:734-261-0985
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003068152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist