Provider Demographics
NPI:1821324435
Name:OLNEY, MICHOLANNE (PT)
Entity Type:Individual
Prefix:
First Name:MICHOLANNE
Middle Name:
Last Name:OLNEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 E JERICHO TPKE UNIT A
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-5453
Mailing Address - Country:US
Mailing Address - Phone:631-549-1550
Mailing Address - Fax:
Practice Address - Street 1:1206 E JERICHO TPKE UNIT A
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-5453
Practice Address - Country:US
Practice Address - Phone:631-549-1550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017095-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist