Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 135373-1 | NY |
N | 207Q00000X | Family Doctor | 135373-1 | NY |
NPI | 1164644589 |
---|---|
Provider Name | Dr. Gary L Ostrow |
First Address | New York, NY 10022-1801 |
Second Address | New York, NY 10022-1801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E51350 | (02) | NY |