| Doctor Name: | OLHA YANISHEVSKA |
| NPI Number: | 1295086072 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 12043 |
| Business Practice Address: | 2284 Sand Trap Rd Jamison, PA - 189291076 |
| Business Phone Number: | 2156948834 |
| Business Fax Number: | |
| Mailing Address: | 2284 Sand Trap Rd, JAMISON |
| State: | PA |
| Postal Code: | 189291076 |
| Phone Number: | 2156948834 |
| Fax Number: | |
| NPI Enumeration Date: | 09/20/2012 |
| NPI Last Update Date: | 09/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 12043 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |