1801834270 NPI number — DR. RIVKA ISABELLE OLLEY PH D

Table of content: DR. RIVKA ISABELLE OLLEY PH D (NPI 1801834270)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801834270 NPI number — DR. RIVKA ISABELLE OLLEY PH D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OLLEY
Provider First Name:
RIVKA
Provider Middle Name:
ISABELLE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OLLEY
Provider Other First Name:
RIVKA
Provider Other Middle Name:
ISABELL
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PH D
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1801834270
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/25/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 SISTER PIERRE DRIVE
Provider Second Line Business Mailing Address:
SUITE 403
Provider Business Mailing Address City Name:
TOWSON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-825-6408
Provider Business Mailing Address Fax Number:
443-279-0537

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 SISTER PIERRE DRIVE
Provider Second Line Business Practice Location Address:
SUITE 403
Provider Business Practice Location Address City Name:
TOWSON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-825-6408
Provider Business Practice Location Address Fax Number:
443-279-0537
Provider Enumeration Date:
06/04/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC1900X , with the licence number:  03668 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TS0200X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 102223 . This is a "TRI GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2136797 . This is a "MAMS INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 252450 . This is a "COMP GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 64518601 . This is a "BSMP INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2512798 . This is a "UNHC GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 362174 . This is a "MHN INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 555465 . This is a "UNHC INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 705BPS . This is a "BSMD GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: K452 . This is a "BSDC GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0023 . This is a "BSDC INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 102223 . This is a "TRI INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 150N117G . This is a "MBMD INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 249586 . This is a "COMP INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 150N . This is a "MBMD GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 360218 . This is a "MHN GROUP" identifier . This identifiers is of the category "OTHER".