Provider Demographics
NPI:1518159292
Name:SIELSKI, KATE S (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:S
Last Name:SIELSKI
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 VARSITY RD
Mailing Address - Street 2:
Mailing Address - City:MASONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15461-2503
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:80 OLD NEW SALEM RD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8902
Practice Address - Country:US
Practice Address - Phone:724-562-8869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008998251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101685026 0001Medicaid