MEDICARE: DR. DOMINICK OLIVO DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	SC007536	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023005378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOMINICK OLIVO DPM

Provider Business Mailing Address
First Line	:	100 N ACADEMY AVE
Second Line	:
City	:	DANVILLE
State	:	PA
Zip	:	17822-4903
Country	:	US
Telephone Number	:	570-308-2564
Fax Number	:	570-308-2566

Provider Business Practice Location Address
First Line	:	255 ROUTE 220 HWY STE 205
Second Line	:
City	:	MUNCY
State	:	PA
Zip	:	17756-7568
Country	:	US
Telephone Number	:	570-308-2564
Fax Number	:	570-308-2566

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	07/22/2025

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Directions to “ DR. DOMINICK OLIVO DPM” Practice Location

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