Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | NY004952 | NY |
NPI | 1144319864 |
---|---|
Provider Name | Dr. Anthony D Olivieri |
First Address | Staten Island, NY 10312-2025 |
Second Address | Staten Island, NY 10312-2025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
600266 | GHI (01) | NY |
OS340 | OXFORD (01) | NY |
U29304 | (02) | NY |