=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538753876
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CUPID MEDICAL PSC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2021
-----------------------------------------------------
Last Update Date | 01/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8 THE GRN STE 11670
-----------------------------------------------------
City | DOVER
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19901-3618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-932-5104
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8 THE GRN STE 11670
-----------------------------------------------------
City | DOVER
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19901-3618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-497-8417
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ANDREY OSTROVSKY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 443-857-8199
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------