Healthcare Provider Details

I. General information

NPI: 1306449624
Provider Name (Legal Business Name): ILANA OSTROVSKY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 11/19/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 NORTH AVE
GARWOOD NJ
07027-1001
US

IV. Provider business mailing address

33 BARCHESTER WAY
WESTFIELD NJ
07090-3747
US

V. Phone/Fax

Practice location:
  • Phone: 908-301-2871
  • Fax: 908-301-2876
Mailing address:
  • Phone: 908-797-4655
  • Fax: 908-301-2876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02443400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: