| Doctor Name: | MR. ALAN BRUCE OLMSTEAD |
| NPI Number: | 1376678243 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RPA-C |
| License Number: | 000724-1 |
| Business Practice Address: | 1 Noryl Ave Selkirk, NY - 121589765 |
| Business Phone Number: | 5184755033 |
| Business Fax Number: | 5184755793 |
| Mailing Address: | 29 Ellsworth Ave, DELMAR |
| State: | NY |
| Postal Code: | 120541419 |
| Phone Number: | 5184755033 |
| Fax Number: | 5184755793 |
| NPI Enumeration Date: | 02/22/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 000724-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |