MEDICARE: MS. IZABELLA OSTOLSKI PA-C

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	363A00000X	Physician Assistant	PA1308	NV

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
2	464885917	OTHER	NV	TAX ID

General Provider Information

NPI Number	:	1598989691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. IZABELLA OSTOLSKI PA-C

Provider Business Mailing Address
First Line	:	3245 S RAINBOW BLVD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6217
Country	:	US
Telephone Number	:	702-228-4900
Fax Number	:	702-228-1177

Provider Business Practice Location Address
First Line	:	3245 S RAINBOW BLVD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6217
Country	:	US
Telephone Number	:	702-228-4900
Fax Number	:	702-228-1177

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

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	03/17/2016

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