Provider Demographics
NPI:1841469814
Name:OLEARY, JILL KAUFMAN (PA-C)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:KAUFMAN
Last Name:OLEARY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:525 E 68TH ST NEW YORK PRESBYTERIAN HOSPITAL
Mailing Address - Street 2:INPATIENT ONCOLOGY PA SERVICE, #325
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-746-7576
Mailing Address - Fax:646-962-0115
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:INPATIENT ONCOLOGY PA SERVICE, #325
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:212-746-7576
Practice Address - Fax:646-962-0115
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCPA 030528363AS0400X
NY007276363AS0400X, 363AM0700X
NC0010-00643363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical