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General NPI Number Information
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NPI Number | 1194347351
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Entity Type | Individual
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Provider Name | SHITAL OLI MD
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Gender | Male
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Dates
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Enumeration Date | 05/11/2020
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Last Update Date | 01/13/2022
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Provider Practice Location Address
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Address Line | 101 DATES DRIVE, INTERNAL MEDICINE RESIDENCY, CAYUGA
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City | ITHACA
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State | NY
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Zip | 14850
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Country | US
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Telephone | 607-277-2170
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Fax |
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Provider Business Mailing Address
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Address Line | 101 DATES DRIVE, INTERNAL MEDICINE RESIDENCY, CAYUGA
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City | ITHACA
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State | NY
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Zip | 14850
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Country | US
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Telephone | 646-204-5218
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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