Provider Demographics
NPI:1639989106
Name:YAQOOB, OLIVE NAZLI
Entity type:Individual
Prefix:MRS
First Name:OLIVE
Middle Name:NAZLI
Last Name:YAQOOB
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 1:325 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-2857
Mailing Address - Country:US
Mailing Address - Phone:203-808-1658
Mailing Address - Fax:
Practice Address - Street 1:325 ACADEMY RD
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2857
Practice Address - Country:US
Practice Address - Phone:203-808-1658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter