Healthcare Provider Details

I. General information

NPI: 1780841924
Provider Name (Legal Business Name): OLA PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 08/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3032 CORLEAR AVE
BRONX NY
10463-5141
US

IV. Provider business mailing address

3032 CORLEAR AVE
BRONX NY
10463-5141
US

V. Phone/Fax

Practice location:
  • Phone: 718-548-4040
  • Fax: 718-548-3939
Mailing address:
  • Phone: 718-548-4040
  • Fax: 718-548-3939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANA OLIVERO
Title or Position: PRESIDENT
Credential: MD
Phone: 718-548-4040