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General NPI Number Information
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NPI Number | 1518886415
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Entity Type | Organization
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Legal Business Name | OLIVIA MEDICINE PC
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Dates
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Enumeration Date | 07/14/2026
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Last Update Date | 07/14/2026
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Provider Practice Location Address
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Address Line | 1131 STATE ROUTE 55
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City | LAGRANGEVILLE
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State | NY
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Zip | 12540-5054
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Country | US
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Telephone | 917-740-3853
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Fax |
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Provider Business Mailing Address
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Address Line | 5308 13TH AVE STE 558
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City | BROOKLYN
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State | NY
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Zip | 11219-5198
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | OLIVIA GIBSON-DELANEY
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Credential |
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Telephone | 917-740-3853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084A2900X
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Taxonomy Name | Neurocritical Care Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084B0002X
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Taxonomy Name | Obesity Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
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License Number |
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Taxonomy #6
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Taxonomy Code | 2084E0001X
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Taxonomy Name | Epilepsy Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2084P0015X
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Taxonomy Name | Psychosomatic Medicine Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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