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General NPI Number Information
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NPI Number | 1982668885
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Entity Type | Organization
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Legal Business Name | ELK REGIONAL PROFESSIONAL GROUP, INC.
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 104 METOXET STREET
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City | RIDGWAY
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State | PA
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Zip | 15853
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Country | US
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Telephone | 814-788-5456
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Fax | 814-772-7278
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Provider Business Mailing Address
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Address Line | 763 JOHNSONBURG RD
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City | ST MARYS
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State | PA
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Zip | 15857-3417
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Country | US
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Telephone | 814-788-8580
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Fax | 814-788-8042
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | RITA V OLSZEWSKI
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Credential |
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Telephone | 814-788-8580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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