MRS. OLESYA ALEXIS DMYTRYK (NPI# 1164732855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164732855 |
Entity Type | Individual |
Full Name | MRS. OLESYA ALEXIS DMYTRYK |
Credential | PMHNP |
Practice Address |
4900 Broad Rd Syracuse NY 13215-2265 |
Mailing Address |
138 Robbins Ln De Witt NY 13214-1834 |
Practice Telephone | 3154925636 |
Mailing Telephone | 3153176982 |
Enumeration Date | 2010-10-14 |
Last Update Date | 2015-03-14 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
401295 | NY | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
4900 BROAD RD |
City | SYRACUSE |
State | NY |
Zip Code | 13215-2265 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336143221 | David C Canfield | Anesthesiology | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2005-06-08 |
1205474335 | Meaghan Porter | Physical Therapist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2019-12-19 |
1982262655 | Ryan Christopher Staib | Nurse Anesthetist, Certified Registered | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2019-05-29 |
1164989505 | Jessica Detor | Social Worker | 4900 Broad Rd, Physician Office Building North 3n, Syracuse, NY 13215-2265 | 2019-02-21 |
1316402415 | Oleksandr Kaplun | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2019-02-04 |
1003390204 | Ianna Javier Garcia | Occupational Therapist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2018-09-24 |
1194207241 | Rebekah Schu | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2018-09-05 |
1669990065 | Katrina E Garrigan | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-09-06 |
1336667948 | Kristy Mcgough | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-09-04 |
1285158402 | Nicholas David Treinin | Pharmacist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-07-30 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396367785 | Jeffrey Alan Gaulrapp | Registered Nurse | Upstate University Hospital Community General Campus, 4900 Broad Road, Syracuse, NY 13215 | 2020-05-08 |
1134752454 | Crystal Elizabeth Hoban | Marriage & Family Therapist | 4922 W. Seneca Turnpike, Syracuse, NY 13215 | 2020-02-14 |
1083004907 | Roger G Levine Md | Psychiatric Residential Treatment Facility | 4914 West Seneca Turnpkie, Syracuse, NY 13215 | 2015-01-30 |
1558771071 | Edleanna Robinson | Licensed Practical Nurse | 5075 W Seneca Turnpike, Syracuse, NY 13215 | 2014-05-06 |
1689013450 | Rhonda Lee Philopena | Emergency Medicine | 4900 Broad Rd 1st Fl, Syracuse, NY 13215 | 2013-06-14 |
1962778498 | Marie Anne Stevens | Licensed Practical Nurse | 4057 Seneca Tpk, Van Duyn Home and Hospital, Syracuse, NY 13215 | 2012-03-29 |
1033439088 | Anna-marie Simpson | Chiropractor | 4922 W Seneca Tpke, Syracuse, NY 13215 | 2010-06-01 |
1992028690 | A John Wylie | Pharmacist | 4840 Sherwood Dr., Syracuse, NY 13215 | 2010-03-09 |
1669616512 | Asalim A Thabet | Emergency Medicine | 4900 Braod Rd, 1st Fl, Syracuse, NY 13215 | 2009-04-22 |
1992948707 | Jesse Reed Gutnick | Surgery | 4900 Borad Rd, Suite 23 North, Syracuse, NY 13215 | 2009-04-08 |
Find all providers in zip 13215 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679198857 | Syed Fazal Shah | Nurse Practitioner | 719 Harrison St Rm 126, Syracuse, NY 13210-2305 | 2020-06-12 |
1023675881 | John Justin Ringhisen | Nurse Practitioner | 500 Harrison St Apt 803, Syracuse, NY 13202-3003 | 2019-05-28 |
1720535099 | I - View Psychiatric Np Behavioral Therapy PC | Nurse Practitioner | 5640 E Taft Rd, 5096, Syracuse, NY 13220-9810 | 2016-09-04 |
1255696811 | Tammy L Balamut | Nurse Practitioner | 404 Oak St Ste 263, Syracuse, NY 13203-2976 | 2012-07-10 |
1558648733 | Jacquelynn Schultz Duquette | Nurse Practitioner | Suny Upstate Child and Adolescent Psychiatry Clinic, 713 Harrison Street, Syracuse, NY 13210 | 2011-11-15 |
1265030753 | Mallory Conner | Nurse Practitioner | 736 Irving Ave, Syracuse, NY 13210-1687 | 2020-10-15 |
1396361473 | Sydney Meadows | Nurse Practitioner | 847 James St, Syracuse, NY 13203-2504 | 2020-06-24 |
1346866829 | Candace S. Carter | Nurse Practitioner | 719 Harrison St, Syracuse, NY 13210-2305 | 2020-06-22 |
1508482282 | Yichao Zhang | Nurse Practitioner | 750 E Adams St, Syracuse, NY 13210-2306 | 2020-06-18 |
1871142687 | Brian Dewayne Frank | Nurse Practitioner | 750 E Adams St, Syracuse, NY 13210-1834 | 2019-09-05 |
Find all providers in SYRACUSE |
Please comment or provide details below to improve the information on MRS. OLESYA ALEXIS DMYTRYK.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.