Provider Demographics
NPI:1356767511
Name:WALKER, OLGA (MSRDN)
Entity type:Individual
Prefix:MS
First Name:OLGA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:MSRDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CLARA CT
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-1541
Mailing Address - Country:US
Mailing Address - Phone:914-231-2510
Mailing Address - Fax:914-231-2513
Practice Address - Street 1:36 CLARA CT
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-1541
Practice Address - Country:US
Practice Address - Phone:914-231-2510
Practice Address - Fax:914-231-2513
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002688-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered