Provider Demographics
NPI:1528377645
Name:ADVANCED HOLISTIC GROUP
Entity Type:Organization
Organization Name:ADVANCED HOLISTIC GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:BARBARA
Authorized Official - Last Name:OSTOLSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:212-253-5501
Mailing Address - Street 1:200 PARK AVE SOUTH
Mailing Address - Street 2:SUITE 1103
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-253-5501
Mailing Address - Fax:212-253-5502
Practice Address - Street 1:200 PARK AVE SOUTH
Practice Address - Street 2:SUITE 1103
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-253-5501
Practice Address - Fax:212-253-5502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210823133N00000X, 171100000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty