Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 30306369 | NY |
NPI | 1003156423 |
---|---|
Provider Name | Adriana Olivo |
First Address | New York, NY 10065-6800 |
Second Address | New York, NY 10065-6800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2013 |
Last Update Date | 21/02/2013 |