Healthcare Provider Details

I. General information

NPI: 1376490698
Provider Name (Legal Business Name): ERICK D OLIVAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RHODE ISLAND AVE NE APT 2
WASHINGTON DC
20002-1307
US

IV. Provider business mailing address

1 RHODE ISLAND AVE NE APT 2
WASHINGTON DC
20002-1307
US

V. Phone/Fax

Practice location:
  • Phone: 202-820-2750
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberT20140
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: