Provider Demographics
NPI:1285818872
Name:HARTMAN-OLSEN, SUSAN PAULINE
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:PAULINE
Last Name:HARTMAN-OLSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 PARK PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-3906
Mailing Address - Country:US
Mailing Address - Phone:917-608-0610
Mailing Address - Fax:
Practice Address - Street 1:508 W 26TH ST
Practice Address - Street 2:10TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5504
Practice Address - Country:US
Practice Address - Phone:646-230-9292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006164-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist