MEDICARE: JENNIFER HELEN OSTROW MSW

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1497134894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER HELEN OSTROW MSW

Provider Business Mailing Address
First Line	:	3490 ROUTE 52
Second Line	:
City	:	PINE BUSH
State	:	NY
Zip	:	12566-5439
Country	:	US
Telephone Number	:	845-800-1615
Fax Number	:

Provider Business Practice Location Address
First Line	:	3490 ROUTE 52
Second Line	:
City	:	PINE BUSH
State	:	NY
Zip	:	12566-5439
Country	:	US
Telephone Number	:	845-800-1615
Fax Number	:

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

Provider Enumeration Date	:	05/19/2015
Last Update Date	:	05/19/2015

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