Healthcare Provider Details

I. General information

NPI: 1023130200
Provider Name (Legal Business Name): LAURA JEAN OLIVIERI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA JEAN COOPER MD

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 12/23/2022
Certification Date: 12/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GRANT ST FL 58
PITTSBURGH PA
15219-2739
US

IV. Provider business mailing address

4401 PENN AVE DIVISION OF CARDIOLOGY, CHILDREN'S HOSPITAL PITTSBURGH
PITTSBURGH PA
15201
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-5325
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberMD476593
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD12108
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: