Provider Demographics
NPI:1790154219
Name:BLACHNO, OLIVIA CATHARYN
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:CATHARYN
Last Name:BLACHNO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 RED HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-1514
Mailing Address - Country:US
Mailing Address - Phone:914-329-0277
Mailing Address - Fax:
Practice Address - Street 1:740 W CHIMES ST
Practice Address - Street 2:APT. 2023
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-8339
Practice Address - Country:US
Practice Address - Phone:914-329-0277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program