Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 211704-1 | NY |
NPI | 1003819368 |
---|---|
Provider Name | Dr. Robert H Oliver |
First Address | Rochester, NY 14621-2731 |
Second Address | Rochester, NY 14621-2731 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 05/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01915420 | (05) | NY |
G26876 | (02) | NY |