Provider Demographics
NPI:1295792810
Name:OLIVERI, ANTHONY CHRISTOPHER (PT)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:CHRISTOPHER
Last Name:OLIVERI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 831
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-0831
Mailing Address - Country:US
Mailing Address - Phone:585-217-2697
Mailing Address - Fax:585-671-5242
Practice Address - Street 1:1670 EMPIRE BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2119
Practice Address - Country:US
Practice Address - Phone:585-217-2697
Practice Address - Fax:585-671-5242
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008582-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
BB3947Medicare PIN
NYAA0179Medicare PIN