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General NPI Number Information
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NPI Number | 1215260575
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Entity Type | Individual
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Provider Name | CHRISTY L OLEZESKI PHD
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Gender | Female
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Dates
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Enumeration Date | 09/17/2009
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Last Update Date | 06/11/2018
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Provider Practice Location Address
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Address Line | 1 LONG WHARF DR FL 5
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City | NEW HAVEN
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State | CT
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Zip | 06511
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Country | US
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Telephone | 929-224-4775
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Fax |
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Provider Business Mailing Address
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Address Line | 774 TOWNSEND AVE
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City | NEW HAVEN
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State | CT
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Zip | 06512-5018
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Country | US
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Telephone | 929-224-4775
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 019218
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3318
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License Number State | CT
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