Individual
GARY E. OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4590 EDGMONT AVE, BROOKHAVEN, PA 19015-1728
(610) 872-6077
(610) 872-2845
Mailing address
4590 EDGMONT AVE, BROOKHAVEN, PA 19015-1728
(610) 872-6077
(610) 872-2845
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001880
PA
152W00000X
Optometrist
TUV005129
NY
Other
Enumeration date
09/29/2006
Last updated
02/01/2017
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