Provider Demographics
NPI:1528777232
Name:PARMETER, OLIVIA M (PHD)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:M
Last Name:PARMETER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 104
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:NY
Mailing Address - Zip Code:13658-0104
Mailing Address - Country:US
Mailing Address - Phone:315-250-2744
Mailing Address - Fax:
Practice Address - Street 1:981 FORD ST EXT
Practice Address - Street 2:
Practice Address - City:OGDENSBURG
Practice Address - State:NY
Practice Address - Zip Code:13669
Practice Address - Country:US
Practice Address - Phone:315-393-7153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069756183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist