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General NPI Number Information
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NPI Number | 1053274290
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Entity Type | Individual
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Provider Name | ALIX OSTEMPOWSKI
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Gender | Male
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 360 TOLLAND TPKE STE 2F
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City | MANCHESTER
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State | CT
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Zip | 06042-1770
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Country | US
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Telephone | 203-828-1114
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Fax | 617-807-0958
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Provider Business Mailing Address
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Address Line | PO BOX 748465
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City | ATLANTA
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State | GA
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Zip | 30374-8465
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Country | US
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Telephone | 855-284-7483
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Fax | 617-807-0958
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 11688
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License Number State | CT
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