Healthcare Provider Details

I. General information

NPI: 1437948718
Provider Name (Legal Business Name): ROBIN LEE OLLIVER RN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2025
Last Update Date: 05/03/2025
Certification Date: 05/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 BROADHOLLOW RD STE 201
MELVILLE NY
11747-4833
US

IV. Provider business mailing address

265 BROADHOLLOW RD STE 201
MELVILLE NY
11747-4833
US

V. Phone/Fax

Practice location:
  • Phone: 888-722-2072
  • Fax:
Mailing address:
  • Phone: 888-722-2072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number493217
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: