Healthcare Provider Details

I. General information

NPI: 1023826062
Provider Name (Legal Business Name): CHRISTINA SUZANNE OLVERD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2024
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 NICHOLS RD
FITCHBURG MA
01420-1919
US

IV. Provider business mailing address

PO BOX 415348
BOSTON MA
02241-5348
US

V. Phone/Fax

Practice location:
  • Phone: 978-343-5048
  • Fax:
Mailing address:
  • Phone: 800-225-8885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA102479
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: