Basic Information
Provider Information | |||||||||
NPI: | 1861478927 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | OLIVEROS | ||||||||
FirstName: | AMORMIO | ||||||||
MiddleName: | M. | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | C.R.N.A. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2690 SOUTHFIELD DRIVE | ||||||||
Address2: |   | ||||||||
City: | YORK | ||||||||
State: | PA | ||||||||
PostalCode: | 174034510 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7177411414 | ||||||||
FaxNumber: | 7177414774 | ||||||||
Practice Location | |||||||||
Address1: | 2690 SOUTHFIELD DRIVE | ||||||||
Address2: |   | ||||||||
City: | YORK | ||||||||
State: | PA | ||||||||
PostalCode: | 174034510 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7177411414 | ||||||||
FaxNumber: | 7177414774 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 12/21/2005 | ||||||||
LastUpdateDate: | 12/09/2014 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN262858L | PA | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |   |
ID Information
ID | Type | State | Issuer | Description | 254658 | 01 | PA | UNISON HEALTH PLAN | OTHER | 693254ZB1B | 01 | PA | MEDICARE | OTHER | 33270 | 01 | PA | GEISINGER HEALTH PLAN | OTHER | P00693224 | 01 | GA | RAILROAD MEDICARE | OTHER | 000693254 | 01 | PA | BLUE SHIELD | OTHER | 0015946900003 | 01 | PA | MEDICAID | OTHER | R99170 | 01 |   | MEDICARE UPIN | OTHER | 50081122 | 01 | PA | CAPITAL BLUECROSS | OTHER |