MEDICARE: DR. WENDY ANN OLIVIER M. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	217393	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114989548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WENDY ANN OLIVIER M. D.

Provider Business Mailing Address
First Line	:	1 BROOKDALE PLAZA
Second Line	:	PHYSICIAN ENTERPRISE
City	:	BROOKLYN
State	:	NY
Zip	:	11212-2907
Country	:	US
Telephone Number	:	718-240-7413
Fax Number	:	718-240-5808

Provider Business Practice Location Address
First Line	:	1 HANSON PL STE 710
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11243-2907
Country	:	US
Telephone Number	:	718-783-0934
Fax Number	:	718-240-5808

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	05/20/2020

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