Provider Demographics
NPI:1063513950
Name:ORSKY, LEE (PA)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:
Last Name:ORSKY
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 192
Mailing Address - Street 2:
Mailing Address - City:UNDERHILL
Mailing Address - State:VT
Mailing Address - Zip Code:05489-0192
Mailing Address - Country:US
Mailing Address - Phone:802-363-7948
Mailing Address - Fax:
Practice Address - Street 1:53 STATE ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-2820
Practice Address - Country:US
Practice Address - Phone:888-663-6331
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0550030196363AM0700X
MAPA4939363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT08V078OtherMVP
VT28070OtherBLUE CROSS BLUE SHIELD
VT28070OtherVERMONT MANAGED CARE
VT9000275Medicaid
VTS91366Medicare UPIN
VT9000275Medicaid