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NPI Code Detail

MEDICARE: MARY F OSTRANDER

MEDICARE: MARY F OSTRANDER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist317791MA

General Provider Information

NPI Number : 1306900055
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY F OSTRANDER
Provider Business Mailing Address
First Line : 801 PLEASANT ST
Second Line :
City : BROCKTON
State : MA
Zip : 02301-3052
Country : US
Telephone Number : 508-586-5977
Fax Number : 508-583-5847
Provider Business Practice Location Address
First Line : 801 PLEASANT ST
Second Line :
City : BROCKTON
State : MA
Zip : 02301-3052
Country : US
Telephone Number : 508-586-5977
Fax Number : 508-583-5847
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 07/08/2007

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Directions to “ MARY F OSTRANDER ” Practice Location

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