Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 46664 | CO |
NPI | 1023223708 |
---|---|
Provider Name | Dr. Jason A Oliviero |
First Address | Manchester, NH 03104-4125 |
Second Address | Manchester, NH 03104-4125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 15/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30208820 | (05) | NH |