Provider Demographics
NPI:1548333024
Name:OLASZ HARKEN, EDIT B (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:EDIT
Middle Name:B
Last Name:OLASZ HARKEN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:EDIT
Other - Middle Name:BARBARA
Other - Last Name:OLASZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD,PHD
Mailing Address - Street 1:10000 W BLUEMOUND RD
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4321
Mailing Address - Country:US
Mailing Address - Phone:414-454-4321
Mailing Address - Fax:414-805-3808
Practice Address - Street 1:10000 W BLUEMOUND RD
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-4321
Practice Address - Country:US
Practice Address - Phone:414-454-4321
Practice Address - Fax:414-805-3808
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI48592-020207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1548333024Medicaid
WI1548333024Medicaid