Provider Demographics
NPI:1154459030
Name:OSTROWSKI, ROMAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ROMAN
Middle Name:M
Last Name:OSTROWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:242 EAST 19TH STREET
Mailing Address - Street 2:#3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4297
Mailing Address - Country:US
Mailing Address - Phone:212-475-6249
Mailing Address - Fax:212-533-9428
Practice Address - Street 1:242 EAST 19TH STREET
Practice Address - Street 2:#3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4297
Practice Address - Country:US
Practice Address - Phone:212-475-6249
Practice Address - Fax:212-533-9428
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2011-09-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY169726207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01410159Medicaid
03E982Medicare PIN
NY01410159Medicaid