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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023530342 NPPES
South Carolina MEDICAID 3448PA

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