Healthcare Provider Details

I. General information

NPI: 1205488129
Provider Name (Legal Business Name): CHRISTINA OLIVIERI FNP, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2019
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 MASON AVENUE BUILDING C, 3RD FLOOR
STATEN ISLAND NY
10305
US

IV. Provider business mailing address

452 INGRAM AVE FL 2
STATEN ISLAND NY
10314-4416
US

V. Phone/Fax

Practice location:
  • Phone: 718-226-6398
  • Fax:
Mailing address:
  • Phone: 646-207-2143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF344024
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ01308700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: