Healthcare Provider Details

I. General information

NPI: 1730173618
Provider Name (Legal Business Name): CYNTHIA M OLESKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 SUNSET AVE
WESTHAMPTON BEACH NY
11978-2331
US

IV. Provider business mailing address

700 HICKSVILLE RD STE 205
BETHPAGE NY
11714-3472
US

V. Phone/Fax

Practice location:
  • Phone: 631-953-4500
  • Fax: 631-953-4570
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD 417233
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: