Efren Olivo MD PC

Organization Active NPI Obstetrics & Gynecology Physician · Bardonia, NY

NPI 1578879490 · NPPES record last updated Aug 30, 2010

Key facts

NPI
1578879490
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
091115 (NY)
Legal business name
EFREN OLIVO MD PC
Practice address
521 Route 304
Bardonia, NY 10954-1620
Phone
(845) 623-7880
Fax
(845) 623-3228
NPI assigned
Aug 30, 2010
Organization subpart
No

Authorized official

Name
Dr. Efren Olivo, MD
Title
President
Phone
(845) 623-7800

National Provider Directory

Locations

521 Route 304
Bardonia, NY 10954
Phone (845) 623-7880

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207V00000X 091115 NY Yes

Addresses

Primary practice location

521 Route 304
Bardonia, NY 10954-1620

Mailing address

521 Route 304
Bardonia, NY 10954-1620
Phone (845) 623-7880

Other identifiers

IdentifierTypeStateIssuer
00496011MedicaidNY

Other providers in Bardonia, NY

All providers in Bardonia, NY · Obstetrics & Gynecology Physician in New York

Sources for this page

Verify at the official NPI Registry.