Healthcare Provider Details

I. General information

NPI: 1316816713
Provider Name (Legal Business Name): OKSANA V CASELLA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 VINE ST
SCRANTON PA
18510-2126
US

IV. Provider business mailing address

24 GARBER ST
OLD FORGE PA
18518-2104
US

V. Phone/Fax

Practice location:
  • Phone: 570-344-6177
  • Fax:
Mailing address:
  • Phone: 888-531-2204
  • Fax: 888-531-2204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTE1004850
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: