Provider Demographics
NPI:1558705996
Name:OLIVERIO, ROBERT JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:OLIVERIO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910C HERITAGE HLS
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-3121
Mailing Address - Country:US
Mailing Address - Phone:914-669-5980
Mailing Address - Fax:914-669-5587
Practice Address - Street 1:910C HERITAGE HLS
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:NY
Practice Address - Zip Code:10589-3121
Practice Address - Country:US
Practice Address - Phone:914-669-5980
Practice Address - Fax:914-669-5587
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-27
Last Update Date:2013-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092534207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology