Basic Information
Provider Information | |||||||||
NPI: | 1245407337 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | OSTROW | ||||||||
FirstName: | VLADY | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | D.O. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 8000 | ||||||||
Address2: | DEPT 596 | ||||||||
City: | BUFFALO | ||||||||
State: | NY | ||||||||
PostalCode: | 142670002 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8662950041 | ||||||||
FaxNumber: | 7083422517 | ||||||||
Practice Location | |||||||||
Address1: | 180 AVENUE AT THE CMN | ||||||||
Address2: | SUITE 7B | ||||||||
City: | SHREWSBURY | ||||||||
State: | NJ | ||||||||
PostalCode: | 077024569 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7329357143 | ||||||||
FaxNumber: | 7329357245 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/08/2008 | ||||||||
LastUpdateDate: | 02/13/2013 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0205X | OS014024 | PA | N |   | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Endocrinology | 2080P0205X | 25MB08710100 | NJ | Y |   | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Endocrinology |
No ID Information.