Healthcare Provider Details

I. General information

NPI: 1720262397
Provider Name (Legal Business Name): ALLISON MARGOLD OSTROFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON BROOK MARGOLD M.D.

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 01/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 HOLLY HILL LN
GREENWICH CT
06830-6098
US

IV. Provider business mailing address

75 HOLLY HILL LN
GREENWICH CT
06830-6098
US

V. Phone/Fax

Practice location:
  • Phone: 203-869-6960
  • Fax: 203-869-5103
Mailing address:
  • Phone: 203-869-6960
  • Fax: 203-869-5103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number048433
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number048433
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: