Individual
MR. OLEG COOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
126 E CHURCH ST STE 2100, SOMERSET, PA 15501-2271
(814) 443-1281
(814) 443-3214
Mailing address
126 E CHURCH ST STE 2100, SOMERSET, PA 15501-2271
(814) 443-1281
(814) 443-3214
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA001256L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001452375
BLUE SHIELD PROVIDER #
PA
Enumeration date
08/10/2006
Last updated
03/11/2021
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