Provider Demographics
NPI:1649793142
Name:OLYMPIA SERVICES INC
Entity type:Organization
Organization Name:OLYMPIA SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KATNOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-709-5114
Mailing Address - Street 1:1913 OLYMPIA BLVD.
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306
Mailing Address - Country:US
Mailing Address - Phone:917-709-5114
Mailing Address - Fax:718-228-6339
Practice Address - Street 1:1913 OLYMPIA BLVD.
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306
Practice Address - Country:US
Practice Address - Phone:917-709-5114
Practice Address - Fax:718-228-6339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty