Provider Demographics
NPI:1629930235
Name:OLIENSIS, MARLENA (CBS)
Entity type:Individual
Prefix:
First Name:MARLENA
Middle Name:
Last Name:OLIENSIS
Suffix:
Gender:F
Credentials:CBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 DRIGGS AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-5533
Mailing Address - Country:US
Mailing Address - Phone:845-653-6994
Mailing Address - Fax:
Practice Address - Street 1:804 DRIGGS AVE APT 4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-5533
Practice Address - Country:US
Practice Address - Phone:845-653-6994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-02
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN