Provider Demographics
NPI:1639557408
Name:BEGASSE DE DHAEM, OLIVIA ANNA JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:ANNA JEAN
Last Name:BEGASSE DE DHAEM
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1275 SUMMER STREET SUITE 306
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5315
Mailing Address - Country:US
Mailing Address - Phone:203-306-2949
Mailing Address - Fax:203-884-8939
Practice Address - Street 1:1275 SUMMER STREET SUITE 306
Practice Address - Street 2:1275 SUMMER STREET SUITE 306
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5315
Practice Address - Country:US
Practice Address - Phone:203-306-2949
Practice Address - Fax:203-884-8939
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-13
Last Update Date:2025-01-15
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Provider Licenses
StateLicense IDTaxonomies
MA2778152084N0400X
CT649192084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology