MEDICARE: OLA PEDIATRICS

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	208000000X	Pediatrics Physician

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	:	1780841924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLA PEDIATRICS

Provider Business Mailing Address
First Line	:	3032 CORLEAR AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-5141
Country	:	US
Telephone Number	:	718-548-4040
Fax Number	:	718-548-3939

Provider Business Practice Location Address
First Line	:	3032 CORLEAR AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-5141
Country	:	US
Telephone Number	:	718-548-4040
Fax Number	:	718-548-3939

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANA OLIVERO
Credential	:	MD
Telephone Number	:	718-548-4040

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	08/21/2014

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Directions to “OLA PEDIATRICS ” Practice Location

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