Provider Demographics
NPI:1629356225
Name:OSTROVSKIY, GRIGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:GRIGORY
Middle Name:
Last Name:OSTROVSKIY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:30 PROSPECT AVE
Mailing Address - Street 2:DEPARTMENT OF NEUROLOGY
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601
Mailing Address - Country:US
Mailing Address - Phone:551-996-8100
Mailing Address - Fax:551-996-4140
Practice Address - Street 1:30 PROSPECT AVE
Practice Address - Street 2:DEPARTMENT OF NEUROLOGY
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601
Practice Address - Country:US
Practice Address - Phone:551-996-8100
Practice Address - Fax:551-996-4140
Is Sole Proprietor?:No
Enumeration Date:2011-07-30
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY280441207P00000X
NJ25MA115773002084A2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine