Individual
MR. BRIAN OLIVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
10460 QUEENS BLVD, 7S, FOREST HILLS, NY 11375-7318
(646) 591-3450
Mailing address
10460 QUEENS BLVD, 7S, FOREST HILLS, NY 11375-7318
(646) 591-3450
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
020548-1
NY
Other
Enumeration date
03/29/2011
Last updated
03/29/2011
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