Provider Demographics
NPI:1720061393
Name:OAKLEY, ESTHER M (MD)
Entity Type:Individual
Prefix:DR
First Name:ESTHER
Middle Name:M
Last Name:OAKLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ESTHER
Other - Middle Name:M
Other - Last Name:VANDYKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 GUTHRIE SQ
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840-1625
Mailing Address - Country:US
Mailing Address - Phone:570-888-5858
Mailing Address - Fax:
Practice Address - Street 1:1 GUTHRIE SQ
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840-1625
Practice Address - Country:US
Practice Address - Phone:570-888-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066348L207P00000X, 207Q00000X
NY215766-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017319680001Medicaid
NY01915920Medicaid
PA080160028OtherRR MEDICARE PIN
PAGU039851OtherPA MEDICARE GROUP
PACC9269OtherRR MEDICARE GROUP
G85444Medicare UPIN
NYCC8683Medicare ID - Type Unspecified
PA080160028OtherRR MEDICARE PIN
PAGU039851OtherPA MEDICARE GROUP
PA930123104Medicare PIN