1730173618 NPI number — DR. CYNTHIA M OLESKI M.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730173618 NPI number — DR. CYNTHIA M OLESKI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OLESKI
Provider First Name:
CYNTHIA
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730173618
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/13/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 HICKSVILLE RD STE 205
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHPAGE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11714-3472
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
131 SUNSET AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTHAMPTON BEACH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11978-2331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-953-4500
Provider Business Practice Location Address Fax Number:
631-953-4570
Provider Enumeration Date:
09/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD 417233 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1875032 . This is a "FREEDOM BLUE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 75290 E465 . This is a "GEISINGER GOLD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000193866 . This is a "MED PLUS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0001394698 . This is a "BC/BS PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1875032 . This is a "BLUE SHIELD BC/BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1875032 . This is a "FIRST PRIORITY HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1875032 . This is a "FIRST PRIORITY LIFE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 892539-01 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0007117393 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 75290 E465 . This is a "GEISINGER HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P00338730 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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