Provider Demographics
NPI:1356470892
Name:OLIVO, MARIA A (OD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:A
Last Name:OLIVO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636 ROUTE 38 STE 48
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-2988
Mailing Address - Country:US
Mailing Address - Phone:609-702-7300
Mailing Address - Fax:609-702-7385
Practice Address - Street 1:1636 ROUTE 38 STE 48
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-2988
Practice Address - Country:US
Practice Address - Phone:609-702-7300
Practice Address - Fax:609-702-7385
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOA05517152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3046351OtherAETNA
NJ115660OtherEYEMED
NJ115660OtherEYEMED
NJ067464Medicare ID - Type Unspecified