Healthcare Provider Details

I. General information

NPI: 1265884779
Provider Name (Legal Business Name): SHERYL ONDREJKO DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2016
Last Update Date: 10/15/2020
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 LIBERTY AVE STE 120
PITTSBURGH PA
15224
US

IV. Provider business mailing address

4815 LIBERTY AVE STE 120
PITTSBURGH PA
15224-2156
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-6444
  • Fax: 412-605-6342
Mailing address:
  • Phone: 412-359-6444
  • Fax: 412-605-6342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberSP018245
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number45037
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSP018245
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: