Provider Demographics
NPI:1588126775
Name:MITELMAN, OLGA (MD)
Entity type:Individual
Prefix:DR
First Name:OLGA
Middle Name:
Last Name:MITELMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 SLEEPER ST APT 405
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02210-1203
Mailing Address - Country:US
Mailing Address - Phone:617-909-4359
Mailing Address - Fax:
Practice Address - Street 1:33 SLEEPER ST APT 405
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02210-1203
Practice Address - Country:US
Practice Address - Phone:617-909-4359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator