Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD12108 | RI |
N | 2080P0202X | Pediatric Cardiologist | MD36624 | DC |
NPI | 1023130200 |
---|---|
Provider Name | Laura Jean Olivieri |
First Address | Bethesda, MD 20814-5732 |
Second Address | Washington, DC 20010-2916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 24/08/2011 |