MEDICARE: DR. MARTIN GEORGE OSTRO M.D.

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
1	207K00000X	Allergy & Immunology Physician	42186	MA
2	207R00000X	Internal Medicine Physician	42186	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467423848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN GEORGE OSTRO M.D.

Provider Business Mailing Address
First Line	:	1101 BEACON ST
Second Line	:	SUITE 7 EAST
City	:	BROOKLINE
State	:	MA
Zip	:	02446-5540
Country	:	US
Telephone Number	:	617-734-2202
Fax Number	:	617-734-2408

Provider Business Practice Location Address
First Line	:	1101 BEACON ST
Second Line	:	SUITE 7 EAST
City	:	BROOKLINE
State	:	MA
Zip	:	02446-5540
Country	:	US
Telephone Number	:	617-734-2202
Fax Number	:	617-734-2408

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	09/23/2011

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