Provider Demographics
NPI:1285433672
Name:OG NURSE PRACTITIONER IN ADULT HEALTH PLLC
Entity type:Organization
Organization Name:OG NURSE PRACTITIONER IN ADULT HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:OLIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLIMOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:716-320-3504
Mailing Address - Street 1:10175 NIAGARA FALLS BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-2941
Mailing Address - Country:US
Mailing Address - Phone:716-320-3504
Mailing Address - Fax:716-320-3505
Practice Address - Street 1:10175 NIAGARA FALLS BLVD STE 1
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-2941
Practice Address - Country:US
Practice Address - Phone:716-320-3504
Practice Address - Fax:716-320-3505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty