Provider Demographics
NPI:1588730261
Name:OLGA'S CORSET AND SPECIALTY SHOP INC.
Entity type:Organization
Organization Name:OLGA'S CORSET AND SPECIALTY SHOP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANHALT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-338-2201
Mailing Address - Street 1:2753 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-5324
Mailing Address - Country:US
Mailing Address - Phone:718-338-2201
Mailing Address - Fax:718-338-9500
Practice Address - Street 1:2753 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-5324
Practice Address - Country:US
Practice Address - Phone:718-338-2201
Practice Address - Fax:718-338-9500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0235400001Medicare ID - Type Unspecified