NPI 1033495684

Alan Olson

Practitioner Medical Physician Assistant Bridgeport, CT

Practice location

Address: 267 Grant St, Bridgeport, CT 06610-2805
Phone: (203) 384-3000
Mailing address: 77 Chestnut Dr, Derby, CT 06418-2310

Registered specialties

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence 002643 (CT)

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Registry record

NPI: 1033495684
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Oct 2011
Record last updated: 27 Oct 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.