Provider Demographics
NPI:1679391205
Name:ALMAZAN, OLIVER CARE MEDICAL
Entity type:Individual
Prefix:
First Name:OLIVER
Middle Name:CARE MEDICAL
Last Name:ALMAZAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 LOUISE DR
Mailing Address - Street 2:
Mailing Address - City:MANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08835-1411
Mailing Address - Country:US
Mailing Address - Phone:908-392-7050
Mailing Address - Fax:
Practice Address - Street 1:20 LOUISE DR
Practice Address - Street 2:
Practice Address - City:MANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08835-1411
Practice Address - Country:US
Practice Address - Phone:732-925-7171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJA54866036501782172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver