Provider Demographics
NPI:1740269059
Name:OLIFIERS, EILEEN (BSPT)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:OLIFIERS
Suffix:
Gender:F
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 ROUTE 52
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-4549
Mailing Address - Country:US
Mailing Address - Phone:845-225-3444
Mailing Address - Fax:845-225-3440
Practice Address - Street 1:1100 ROUTE 52
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-4549
Practice Address - Country:US
Practice Address - Phone:845-225-3444
Practice Address - Fax:845-225-3440
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0172071225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQQ9471Medicare ID - Type UnspecifiedPROVIDER NUMBER