Provider Demographics
NPI:1528412319
Name:CHARLES OLINER MD PLLC
Entity Type:Organization
Organization Name:CHARLES OLINER MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:OLINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-902-7501
Mailing Address - Street 1:195 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1409
Mailing Address - Country:US
Mailing Address - Phone:516-902-7501
Mailing Address - Fax:
Practice Address - Street 1:195 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1409
Practice Address - Country:US
Practice Address - Phone:516-902-7501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-18
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty