Healthcare Provider Details

I. General information

NPI: 1821085044
Provider Name (Legal Business Name): ELK REGIONAL PROFESSIONAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

761 JOHNSONBURG RD SUITE 310
ST MARYS PA
15857-3483
US

IV. Provider business mailing address

761 JOHNSONBURG RD SUITE 310
ST MARYS PA
15857-3483
US

V. Phone/Fax

Practice location:
  • Phone: 814-788-8188
  • Fax: 814-834-6291
Mailing address:
  • Phone: 814-788-8188
  • Fax: 814-834-6291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: RITA V OLSZEWSKI
Title or Position: VICE PRESIDENT, ERPG
Credential:
Phone: 814-788-8580