MEDICARE: MR. RICHARD J OLIVIERI MS/OTA

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	224Z00000X	Occupational Therapy Assistant	007262-1	NY

General Provider Information

NPI Number	:	1932422581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD J OLIVIERI MS/OTA

Provider Business Mailing Address
First Line	:	594 MILFORD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-5206
Country	:	US
Telephone Number	:	718-551-2511
Fax Number	:

Provider Business Practice Location Address
First Line	:	3175 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-5700
Country	:	US
Telephone Number	:	718-239-8239
Fax Number	:	718-679-9519

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

Provider Enumeration Date	:	03/11/2010
Last Update Date	:	03/11/2010

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