Provider Demographics
NPI:1083980452
Name:OLVERA DE ARISTE, LILIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:LILIA
Middle Name:
Last Name:OLVERA DE ARISTE
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 1:13521 241ST ST
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-1527
Mailing Address - Country:US
Mailing Address - Phone:718-528-2276
Mailing Address - Fax:718-712-1598
Practice Address - Street 1:13521 241ST ST
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-1527
Practice Address - Country:US
Practice Address - Phone:718-528-2276
Practice Address - Fax:718-712-1598
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY488160163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool