Olivia Ann Fertmann

NPI #1265939904 in Medford, New York

Provider Information

NPI Number: 1265939904
Entity Type: Individual
Name: Olivia Ann Fertmann
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Apr 10, 2018
Last Updated: Apr 10, 2018

Practice Location

Address: 1 SCOUTING BLVD
City: Medford
State: New York
ZIP Code: 11763-2220
Phone: (631) 297-3202

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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