MEDICARE: WITHLINE OLIBRICE

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	225X00000X	Occupational Therapist	031095	NY

General Provider Information

NPI Number	:	1417880154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WITHLINE OLIBRICE

Provider Business Mailing Address
First Line	:	15218 UNION TPKE APT 9C
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-3925
Country	:	US
Telephone Number	:	239-777-8750
Fax Number	:

Provider Business Practice Location Address
First Line	:	15218 UNION TPKE APT 9C
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-3925
Country	:	US
Telephone Number	:	239-777-8750
Fax Number	:

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

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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Directions to “ WITHLINE OLIBRICE ” Practice Location

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