Provider Demographics
NPI:1073499638
Name:REDA, OLIVIA R (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:OLIVIA
Middle Name:R
Last Name:REDA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N CENTRAL AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1949
Mailing Address - Country:US
Mailing Address - Phone:914-535-7701
Mailing Address - Fax:
Practice Address - Street 1:210 N CENTRAL AVE STE 230
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1949
Practice Address - Country:US
Practice Address - Phone:914-535-7701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY353338208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice