Healthcare Provider Details

I. General information

NPI: 1881652907
Provider Name (Legal Business Name): ROBERT JOHN OSTRANDER M D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 12/10/2021
Certification Date: 12/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 STATE ROUTE 245
RUSHVILLE NY
14544-9604
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 585-554-3119
  • Fax: 585-554-3323
Mailing address:
  • Phone: 585-554-3119
  • Fax: 585-554-3323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number160360
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number160360
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: