Provider Demographics
NPI:1619456407
Name:OLAVE-PICHON, ALICIA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:OLAVE-PICHON
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 73
Mailing Address - Street 2:SANTA CATALINA APARTMENTS TOWER II APT 105
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-4576
Mailing Address - Country:US
Mailing Address - Phone:773-966-8370
Mailing Address - Fax:
Practice Address - Street 1:CARR 2 KM 11.0
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-474-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR33891-R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics