Provider Demographics
NPI:1326317975
Name:OSTREA, JOAQUIN (PT)
Entity Type:Individual
Prefix:
First Name:JOAQUIN
Middle Name:
Last Name:OSTREA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151-44 82 STREET
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-1777
Mailing Address - Country:US
Mailing Address - Phone:718-738-2550
Mailing Address - Fax:718-738-6644
Practice Address - Street 1:151-44 82 STREET
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-1777
Practice Address - Country:US
Practice Address - Phone:718-738-2550
Practice Address - Fax:718-738-6644
Is Sole Proprietor?:No
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY620325482251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic