Active NPI
Magdalena M Oleszak, MD
- Pediatrics Physician
- Port Jefferson Station, NY
National Provider Identifier
1710955224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 193313
- Practice address
- 815 Hallock Ave
Suite a
Port Jefferson Station, NY 11776-1220 - Phone
- (631) 331-7267
- Fax
- (631) 331-7289
- NPI assigned
- Mar 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 193313 | NY | Primary |
Addresses
Primary practice location
815 Hallock Ave
Suite a
Port Jefferson Station, NY 11776-1220
Mailing address
P.O. Box 1559
Stony Brook, NY 11790
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 193313 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505865600000",
"number": "1710955224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 1559",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "11790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 HALLOCK AVE",
"address_2": "SUITE A",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117761220",
"telephone_number": "631-331-7267",
"fax_number": "631-331-7289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLESZAK",
"first_name": "MAGDALENA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-09",
"last_updated": "2017-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "193313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson Station, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.