MEDICARE: NELSON OLEGARIO PT

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	225100000X	Physical Therapist	017914	NY

General Provider Information

NPI Number	:	1730531526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NELSON OLEGARIO PT

Provider Business Mailing Address
First Line	:	7210 164TH ST
Second Line	:
City	:	FRESH MEADOWS
State	:	NY
Zip	:	11365-4222
Country	:	US
Telephone Number	:	646-510-4251
Fax Number	:

Provider Business Practice Location Address
First Line	:	7210 164TH ST
Second Line	:
City	:	FRESH MEADOWS
State	:	NY
Zip	:	11365-4222
Country	:	US
Telephone Number	:	646-510-4251
Fax Number	:

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

Provider Enumeration Date	:	07/06/2016
Last Update Date	:	07/06/2016

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Directions to “ NELSON OLEGARIO PT” Practice Location

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