Provider Demographics
NPI:1003059643
Name:OLIVERA, ROSANGELA D (RN)
Entity Type:Individual
Prefix:
First Name:ROSANGELA
Middle Name:D
Last Name:OLIVERA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:NORTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10560-2212
Mailing Address - Country:US
Mailing Address - Phone:914-713-4849
Mailing Address - Fax:914-713-4849
Practice Address - Street 1:80 HILLTOP DR
Practice Address - Street 2:
Practice Address - City:NORTH SALEM
Practice Address - State:NY
Practice Address - Zip Code:10560-2212
Practice Address - Country:US
Practice Address - Phone:914-713-4849
Practice Address - Fax:914-713-4849
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-13
Last Update Date:2010-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY582334-1163W00000X
CT086628163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse