Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 239654 | NY |
N | 111NI0900X | Internist | 239654 | NY |
Y | 207RH0002X | Hospice and Palliative Medicine | 239654 | NY |
NPI | 1225086440 |
---|---|
Provider Name | Aaron M Olden |
First Address | Penfield, NY 14526-2045 |
Second Address | Penfield, NY 14526-2045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 29/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00884028 | MEDICARE RAILROAD (01) | NY |