Provider Demographics
NPI:1528038221
Name:OLEX, AMY M (OD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:M
Last Name:OLEX
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:22 BOW CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN TOP
Mailing Address - State:PA
Mailing Address - Zip Code:18707-1523
Mailing Address - Country:US
Mailing Address - Phone:570-956-5197
Mailing Address - Fax:
Practice Address - Street 1:1494 ROUTE 61 HWY S STE 100
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-8404
Practice Address - Country:US
Practice Address - Phone:570-621-5690
Practice Address - Fax:570-622-9285
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000283152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA007714937-0006Medicaid
PA050404Medicare ID - Type Unspecified
PAU86583Medicare UPIN