Provider Demographics
NPI:1518032952
Name:OLEARCHYK, ANDREW S (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:S
Last Name:OLEARCHYK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 WALT WHITMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3746
Mailing Address - Country:US
Mailing Address - Phone:856-428-0505
Mailing Address - Fax:856-428-0505
Practice Address - Street 1:129 WALT WHITMAN BLVD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3746
Practice Address - Country:US
Practice Address - Phone:856-428-0505
Practice Address - Fax:856-428-0505
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03437400208G00000X
PAMD030913L208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0179701Medicaid
PAOL19341OtherPA MEDICARE
B33340Medicare UPIN
NJ542714Medicare ID - Type Unspecified