Healthcare Provider Details

I. General information

NPI: 1528412319
Provider Name (Legal Business Name): CHARLES OLINER MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2016
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 CENTRAL AVE
LAWRENCE NY
11559-1409
US

IV. Provider business mailing address

195 CENTRAL AVE
LAWRENCE NY
11559-1409
US

V. Phone/Fax

Practice location:
  • Phone: 516-902-7501
  • Fax:
Mailing address:
  • Phone: 516-902-7501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES OLINER
Title or Position: OWNER
Credential: MD
Phone: 516-902-7501