Provider Demographics
NPI:1992032791
Name:OLIVIER, ROLANDE (FNP)
Entity Type:Individual
Prefix:MS
First Name:ROLANDE
Middle Name:
Last Name:OLIVIER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722-4017
Mailing Address - Country:US
Mailing Address - Phone:516-427-2477
Mailing Address - Fax:631-630-0667
Practice Address - Street 1:3 OLIVE ST
Practice Address - Street 2:
Practice Address - City:CENTRAL ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11722-4017
Practice Address - Country:US
Practice Address - Phone:516-427-2477
Practice Address - Fax:631-630-0667
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343285363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1992032791Medicaid