Provider Demographics
NPI:1730173618
Name:OLESKI, CYNTHIA M (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:M
Last Name:OLESKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 HICKSVILLE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3472
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:131 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON BEACH
Practice Address - State:NY
Practice Address - Zip Code:11978-2331
Practice Address - Country:US
Practice Address - Phone:631-953-4500
Practice Address - Fax:631-953-4570
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 417233207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1875032OtherFREEDOM BLUE
PA75290 E465OtherGEISINGER GOLD
PA000000193866OtherMED PLUS
PA0001394698OtherBC/BS PERSONAL CHOICE
PA1875032OtherBLUE SHIELD BC/BS
PA1875032OtherFIRST PRIORITY HEALTH
PA1875032OtherFIRST PRIORITY LIFE
PA892539-01Medicaid
PA0007117393OtherAETNA
PA75290 E465OtherGEISINGER HEALTH
PAP00338730OtherRAILROAD MEDICARE
PA1875032OtherBLUE SHIELD BC/BS
PA056340Medicare PIN