Provider Demographics
NPI:1679133300
Name:HRESTAK, HALEY ELISE (DO)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:ELISE
Last Name:HRESTAK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:ELISE
Other - Last Name:MEHALIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2109 HUGHES DR FL 3
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3856
Mailing Address - Country:US
Mailing Address - Phone:419-291-8154
Mailing Address - Fax:419-291-2163
Practice Address - Street 1:2109 HUGHES DR FL 3
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3856
Practice Address - Country:US
Practice Address - Phone:419-291-8154
Practice Address - Fax:419-291-2163
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH34.015845207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program