Provider Demographics
NPI:1669831624
Name:OLIVERIO, PHOEBE (PHARMD)
Entity Type:Individual
Prefix:
First Name:PHOEBE
Middle Name:
Last Name:OLIVERIO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4160
Mailing Address - Country:US
Mailing Address - Phone:908-577-8304
Mailing Address - Fax:
Practice Address - Street 1:129 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-4160
Practice Address - Country:US
Practice Address - Phone:908-577-8304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-19
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH235378183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist