Provider Demographics
NPI:1649938796
Name:BRAMLETT, OLIVIA LEIGH (PT, DPT, CLT, CBIS)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:LEIGH
Last Name:BRAMLETT
Suffix:
Gender:F
Credentials:PT, DPT, CLT, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 CENTRAL PARK W APT 3D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4369
Mailing Address - Country:US
Mailing Address - Phone:917-447-3472
Mailing Address - Fax:
Practice Address - Street 1:446 CENTRAL PARK W APT 3D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4369
Practice Address - Country:US
Practice Address - Phone:917-447-3472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037963208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation