Provider Demographics
NPI:1033548862
Name:OLSZEWSKI, SHAWN (LMT)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:OLSZEWSKI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 OAK LEAF LN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-2860
Mailing Address - Country:US
Mailing Address - Phone:716-204-8556
Mailing Address - Fax:
Practice Address - Street 1:1567 MILITARY RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14217-1264
Practice Address - Country:US
Practice Address - Phone:716-877-0676
Practice Address - Fax:716-877-4248
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025059225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist