Provider Demographics
NPI:1780163790
Name:OLEKSYUK, VALENTYNA (NP)
Entity type:Individual
Prefix:
First Name:VALENTYNA
Middle Name:
Last Name:OLEKSYUK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 FORREST AVE
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-2215
Mailing Address - Country:US
Mailing Address - Phone:585-312-5540
Mailing Address - Fax:585-361-5139
Practice Address - Street 1:104 FORREST AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2215
Practice Address - Country:US
Practice Address - Phone:585-312-5540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2024-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY431313363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05352209Medicaid