Provider Demographics
NPI:1831175512
Name:OLIVIERI, PHILIP J (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:J
Last Name:OLIVIERI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 TEMPE WICK RD
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-1814
Mailing Address - Country:US
Mailing Address - Phone:973-543-2288
Mailing Address - Fax:973-543-0637
Practice Address - Street 1:8 TEMPE WICK RD
Practice Address - Street 2:
Practice Address - City:MENDHAM
Practice Address - State:NJ
Practice Address - Zip Code:07945-1814
Practice Address - Country:US
Practice Address - Phone:973-543-2288
Practice Address - Fax:973-543-0637
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA36434174400000X
NJ25MA03643400207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8053600Medicaid
NJG85727Medicare UPIN
NJ8053600Medicaid