Provider Demographics
NPI:1659531366
Name:RICHARD G. OLARSCH, DO PC
Entity Type:Organization
Organization Name:RICHARD G. OLARSCH, DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:OLARSCH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:609-522-0727
Mailing Address - Street 1:PO BOX 147
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08260-0147
Mailing Address - Country:US
Mailing Address - Phone:609-522-0727
Mailing Address - Fax:609-522-2163
Practice Address - Street 1:4211 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08260-4622
Practice Address - Country:US
Practice Address - Phone:609-522-0727
Practice Address - Fax:609-522-2163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB072240207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8566704Medicaid
NJ049477Medicare PIN
NJ8566704Medicaid