Healthcare Provider Details

I. General information

NPI: 1245407337
Provider Name (Legal Business Name): VLADY OSTROW D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 02/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 AVENUE AT THE CMN SUITE 7B
SHREWSBURY NJ
07702-4569
US

IV. Provider business mailing address

PO BOX 8000 DEPT 596
BUFFALO NY
14267-0002
US

V. Phone/Fax

Practice location:
  • Phone: 732-935-7143
  • Fax: 732-935-7245
Mailing address:
  • Phone: 866-295-0041
  • Fax: 708-342-2517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberOS014024
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number25MB08710100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: