Provider Demographics
NPI:1235712878
Name:DEUTSCH, OLIVIA SARA (FNP)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:SARA
Last Name:DEUTSCH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 COLONY ST
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2427
Mailing Address - Country:US
Mailing Address - Phone:516-639-5298
Mailing Address - Fax:
Practice Address - Street 1:268 COLONY ST
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2427
Practice Address - Country:US
Practice Address - Phone:516-639-5298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-02
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345771363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily