Basic Information
| Provider Information | |||||||||
| NPI: | 1376663997 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | OSTROWITZ | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | BENNETT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 GRAND STREET | ||||||||
| Address2: | 3RD FL | ||||||||
| City: | WARWICK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109901035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8459873906 | ||||||||
| FaxNumber: | 8459875979 | ||||||||
| Practice Location | |||||||||
| Address1: | 3601 SW 160TH AVE | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | MIRAMAR | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330276308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8778667123 | ||||||||
| FaxNumber: | 8558552792 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2007 | ||||||||
| LastUpdateDate: | 09/19/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 94-06681 | KS | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 237452 | NY | Y | Allopathic & Osteopathic Physicians | Surgery | 207Q00000X | 237452 | NY | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.