Provider Demographics
NPI:1124075163
Name:OLVECZKY, DANIELE DJENABA (MD, MSC)
Entity type:Individual
Prefix:DR
First Name:DANIELE
Middle Name:DJENABA
Last Name:OLVECZKY
Suffix:
Gender:F
Credentials:MD, MSC
Other - Prefix:DR
Other - First Name:DANIELE
Other - Middle Name:DJENABA
Other - Last Name:OLVECZKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MSC
Mailing Address - Street 1:245 CONCORD AVENUE
Mailing Address - Street 2:UNIT 15
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1323
Mailing Address - Country:US
Mailing Address - Phone:617-667-7000
Mailing Address - Fax:216-803-4680
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:PALMER BAKER SPAN 2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221808207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine