MEDICARE: MS. JULIE L. OLIVERI LCSW

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	1041C0700X	Clinical Social Worker	R030336-1	NY

General Provider Information

NPI Number	:	1902917115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIE L. OLIVERI LCSW

Provider Business Mailing Address
First Line	:	16 STEVENSON ST
Second Line	:
City	:	LYNBROOK
State	:	NY
Zip	:	11563-1114
Country	:	US
Telephone Number	:	516-812-6082
Fax Number	:	516-812-6082

Provider Business Practice Location Address
First Line	:	7819 MYRTLE AVE
Second Line	:
City	:	GLENDALE
State	:	NY
Zip	:	11385-7439
Country	:	US
Telephone Number	:	718-456-3973
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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