Provider Demographics
NPI:1053447581
Name:OSTROV, JULIA ILENE (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:ILENE
Last Name:OSTROV
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:209 HARVARD ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5071
Mailing Address - Country:US
Mailing Address - Phone:617-277-8558
Mailing Address - Fax:617-277-5594
Practice Address - Street 1:209 HARVARD ST
Practice Address - Street 2:SUITE 301
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5071
Practice Address - Country:US
Practice Address - Phone:617-277-8558
Practice Address - Fax:617-277-5594
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA74514207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3079350Medicaid
MAJ11356Medicare ID - Type Unspecified
MA3079350Medicaid