Basic Information
| Provider Information | |||||||||
| NPI: | 1265641369 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OLESKI | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 399 MARSH ST | ||||||||
| Address2: | |||||||||
| City: | BELMONT | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024781107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7815750255 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 LEDGEWOOD PL | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | ROCKLAND | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023701075 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818716550 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 3707 | MA | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.