Healthcare Provider Details

I. General information

NPI: 1003228412
Provider Name (Legal Business Name): MS. CAITLIN OLVER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 05/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 LINDSLEY DR
MORRISTOWN NJ
07960-4455
US

IV. Provider business mailing address

1804 SCARLETT DR
HACKETTSTOWN NJ
07840-4519
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-0770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number46TR00485800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: