Provider Demographics
NPI:1467772566
Name:OSTROWSKI, CHERYL
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:OSTROWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 MAIN ST
Mailing Address - Street 2:APT. #106
Mailing Address - City:RANDOLPH
Mailing Address - State:NY
Mailing Address - Zip Code:14772-1217
Mailing Address - Country:US
Mailing Address - Phone:716-969-7368
Mailing Address - Fax:
Practice Address - Street 1:270 MAIN ST
Practice Address - Street 2:APT. #106
Practice Address - City:RANDOLPH
Practice Address - State:NY
Practice Address - Zip Code:14772-1217
Practice Address - Country:US
Practice Address - Phone:716-969-7368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205477-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse