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General NPI Number Information
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NPI Number | 1326766775
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Entity Type | Individual
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Provider Name | DR. SHELLY OSTRO
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Gender | Female
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Dates
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Enumeration Date | 08/19/2022
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 1 W 64TH ST
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City | NEW YORK
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State | NY
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Zip | 10023-6734
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Country | US
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Telephone | 929-428-2859
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Fax |
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Provider Business Mailing Address
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Address Line | 318 W 100TH ST APT 5C
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City | NEW YORK
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State | NY
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Zip | 10025-5372
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Country | US
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Telephone | 929-428-2859
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Fax |
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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 | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | 001149
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License Number State | NY
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