Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | F338039-1 | NY |
NPI | 1003255753 |
---|---|
Provider Name | Alicia Olmoz |
First Address | Warwick, NY 10990-1035 |
Second Address | Wappingers Falls, NY 12590-6496 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2013 |
Last Update Date | 05/12/2016 |