Healthcare Provider Details

I. General information

NPI: 1427694355
Provider Name (Legal Business Name): YARDLEY MARIE OLEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2019
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1581 N 9TH ST
STROUDSBURG PA
18360-7531
US

IV. Provider business mailing address

1581 N 9TH ST
STROUDSBURG PA
18360-7531
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-1260
  • Fax:
Mailing address:
  • Phone: 484-526-1260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA061303
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberMA061303
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: