Provider Demographics
NPI:1962178905
Name:OLEYAR, MATTHEW LOUIS (PA-C)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:LOUIS
Last Name:OLEYAR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2097 ALEXANDRIA ST
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:PA
Mailing Address - Zip Code:15627-3601
Mailing Address - Country:US
Mailing Address - Phone:724-610-1539
Mailing Address - Fax:
Practice Address - Street 1:2097 ALEXANDRIA ST
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:PA
Practice Address - Zip Code:15627-3601
Practice Address - Country:US
Practice Address - Phone:724-610-1539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMA062874363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program