Individual
JACQUELINE OLIVIERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPAC
Contact information
Practice address
55 N MAIN ST, FREEPORT, NY 11520-2243
(516) 377-8014
(516) 377-8017
Mailing address
55 N MAIN ST, FREEPORT, NY 11520-2243
(516) 377-8014
(516) 377-8017
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
010927
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010927
LICENSE #
NY
Enumeration date
09/28/2006
Last updated
03/07/2023
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