Provider Demographics
NPI:1760458855
Name:WASILESKI, HEATHER L (DO)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:L
Last Name:WASILESKI
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:77 NELSON ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-1945
Mailing Address - Country:US
Mailing Address - Phone:315-253-4463
Mailing Address - Fax:315-253-5624
Practice Address - Street 1:77 NELSON ST
Practice Address - Street 2:SUITE 310
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-1944
Practice Address - Country:US
Practice Address - Phone:315-253-4463
Practice Address - Fax:315-253-5624
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2015-11-06
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Provider Licenses
StateLicense IDTaxonomies
NH14577207R00000X
NY234048207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine