Basic Information
| Provider Information | |||||||||
| NPI: | 1407165327 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OLIVERI | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 777 SEAVIEW AVENUE | ||||||||
| Address2: | SOUTH BEACH PSYCHIATRIC CENTER BEN OPD | ||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 103053409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182568818 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 777 SEAVIEW AVE | ||||||||
| Address2: | SOUTH BEACH PSYCHIATRIC CENTER - BEN OPD | ||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 103053409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182568818 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2010 | ||||||||
| LastUpdateDate: | 01/27/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0000X | 423886 | NY | Y | Nursing Service Providers | Registered Nurse | General Practice |
No ID Information.