Provider Demographics
NPI:1750852075
Name:OLIVERIO, ANNA-MARIE CANDES
Entity Type:Individual
Prefix:MS
First Name:ANNA-MARIE
Middle Name:CANDES
Last Name:OLIVERIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 N 6TH ST APT 7A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-3777
Mailing Address - Country:US
Mailing Address - Phone:917-509-8478
Mailing Address - Fax:
Practice Address - Street 1:240 E 172ND ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-8903
Practice Address - Country:US
Practice Address - Phone:718-410-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-14
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028340235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist