Provider Demographics
NPI:1871462812
Name:REMILLARD, OLIVIA CLEMO (CPNP-PC, CPNP-AC)
Entity type:Individual
Prefix:MISS
First Name:OLIVIA
Middle Name:CLEMO
Last Name:REMILLARD
Suffix:
Gender:F
Credentials:CPNP-PC, CPNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5146 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13215-2446
Mailing Address - Country:US
Mailing Address - Phone:571-531-0057
Mailing Address - Fax:
Practice Address - Street 1:747 BELDEN AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3348
Practice Address - Country:US
Practice Address - Phone:877-925-3637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT015653363LP0222X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care