Provider Demographics
NPI:1639313414
Name:OLIVER, MELISSA A (MED)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:A
Last Name:OLIVER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:ARNOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:80 E END AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-8004
Mailing Address - Country:US
Mailing Address - Phone:212-585-3500
Mailing Address - Fax:212-585-3300
Practice Address - Street 1:80 E END AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-8004
Practice Address - Country:US
Practice Address - Phone:212-585-3500
Practice Address - Fax:212-585-3300
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY659202061222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist