Healthcare Provider Details

I. General information

NPI: 1871462812
Provider Name (Legal Business Name): OLIVIA CLEMO REMILLARD CPNP-PC, CPNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 10/29/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 BELDEN AVE
NORWALK CT
06850-3348
US

IV. Provider business mailing address

5146 SKYLINE DR
SYRACUSE NY
13215-2446
US

V. Phone/Fax

Practice location:
  • Phone: 877-925-3637
  • Fax:
Mailing address:
  • Phone: 571-531-0057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number015653
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number015653
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: