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General NPI Number Information
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NPI Number | 1831070705
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Entity Type | Individual
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Provider Name | OLIVIA JOSEPH
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Gender | Female
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Dates
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Enumeration Date | 09/09/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 1040 US HIGHWAY 1 STE 103
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City | AVENEL
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State | NJ
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Zip | 07001-1539
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Country | US
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Telephone | 732-582-4224
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Fax |
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Provider Business Mailing Address
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Address Line | 515 W 59TH ST APT 20B
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City | NEW YORK
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State | NY
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Zip | 10019-0205
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Country | US
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Telephone | 845-598-9991
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 22DI03116100
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License Number State | NJ
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