Larussa, Olivia Mae
Larussa, Olivia Mae is an individual health care provider with primary practice located at 900 23Rd St Nw , Washington DC 20037-2342. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Larussa, Olivia Mae can be contacted via phone (202) 741-3000.Contact Information
Primary practice address
900 23Rd St Nw
Washington DC 20037-2342
Phone: (202) 741-3000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | TL2763 | South Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 2763 | South Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA200001702 | District of Columbia |
Profile Details
| NPI number | 1023530342 |
|---|---|
| LBN Legal business name | Larussa, Olivia Mae |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2017 |
| Last updated | Nov 21st, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023530342 | NPPES |
| South Carolina | MEDICAID | 3448PA |
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