Provider Demographics
NPI:1811926348
Name:OLIVIERI, SUZANNE P (MD)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:P
Last Name:OLIVIERI
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 E PENN SQ
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9258
Mailing Address - Fax:267-425-9299
Practice Address - Street 1:3550 MARKET ST FL 4
Practice Address - Street 2:CHOP CARE NETWORK AT 3550 MARKET STREET
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3368
Practice Address - Country:US
Practice Address - Phone:215-590-2178
Practice Address - Fax:215-590-4619
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2014-11-06
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Provider Licenses
StateLicense IDTaxonomies
PAMD041774L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0009253Medicaid
PA0013946610006Medicaid
PA672232Medicare ID - Type Unspecified
NJ0009253Medicaid