Provider Demographics
NPI:1386083442
Name:OLIVEROS SOLES, ESTEFANIA (MD)
Entity type:Individual
Prefix:
First Name:ESTEFANIA
Middle Name:
Last Name:OLIVEROS SOLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 FORT WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3739
Mailing Address - Country:US
Mailing Address - Phone:212-305-4600
Mailing Address - Fax:212-305-7439
Practice Address - Street 1:173 FORT WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3739
Practice Address - Country:US
Practice Address - Phone:212-305-4600
Practice Address - Fax:212-305-7439
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD471167207RA0001X, 207RC0000X
NY298040207RC0000X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease