Provider Demographics
NPI:1245230242
Name:AVI A OSTROWSKY MD LTD
Entity Type:Organization
Organization Name:AVI A OSTROWSKY MD LTD
Other - Org Name:DIABETES & ENDOCRINOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AVI
Authorized Official - Middle Name:A
Authorized Official - Last Name:OSTROWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-360-9210
Mailing Address - Street 1:PO BOX 35192
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-5192
Mailing Address - Country:US
Mailing Address - Phone:702-360-9210
Mailing Address - Fax:702-360-0008
Practice Address - Street 1:3150 N TENAYA WAY
Practice Address - Street 2:STE 440
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0443
Practice Address - Country:US
Practice Address - Phone:702-360-9210
Practice Address - Fax:702-360-0008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-01
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6480207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019771Medicaid
NV34167Medicare PIN
NVF24435Medicare UPIN