Healthcare Provider Details

I. General information

NPI: 1356307698
Provider Name (Legal Business Name): SHERYL LYNN OLESKI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MORGAN HWY SUITE 4
SCRANTON PA
18508-2641
US

IV. Provider business mailing address

5 MORGAN HWY SUITE 4
SCRANTON PA
18508-2641
US

V. Phone/Fax

Practice location:
  • Phone: 570-344-3788
  • Fax: 570-969-9280
Mailing address:
  • Phone: 570-344-3788
  • Fax: 570-969-9280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberOS012550
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberOS012550
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier229469
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerUHC
# 2
Identifier1178692
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerGATEWAY HEALTH
# 3
Identifier108436-1067
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerGEISINGER
# 4
Identifier7029772
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAETNA
# 5
Identifier821945
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE CARE HMO (FPH)
# 6
Identifier001863664
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE CARE
# 7
Identifier50076574
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerCAPITAL BLUE CROSS
# 8
Identifier101835310-0002
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 9
IdentifierP00409072
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerRAILROAD MEDICARE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: