Basic Information
Provider Information
NPI: 1467928697
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OLINGER
FirstName: NASIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 75868
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212755868
CountryCode: US
TelephoneNumber: 7038105211
FaxNumber:  
Practice Location
Address1: 6355 WALKER LN STE 204
Address2:  
City: ALEXANDRIA
State: VA
PostalCode: 223103257
CountryCode: US
TelephoneNumber: 7038105211
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/15/2018
LastUpdateDate: 10/15/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X2305212258VAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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