Healthcare Provider Details

I. General information

NPI: 1396620902
Provider Name (Legal Business Name): OLIVIA ZWERNEMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 RIVER RD STE 14
HARRIMAN NY
10926-3040
US

IV. Provider business mailing address

60 SHARP ST STE 2
HINGHAM MA
02043-4334
US

V. Phone/Fax

Practice location:
  • Phone: 845-320-2855
  • Fax:
Mailing address:
  • Phone: 845-828-6132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-88162
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: