Provider Demographics
NPI:1629373337
Name:OSTROVSKAYA, TATYANA (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:TATYANA
Middle Name:
Last Name:OSTROVSKAYA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 W 5TH ST
Mailing Address - Street 2:APT 21G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3907
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2915 W 5TH ST
Practice Address - Street 2:APT 21G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-3907
Practice Address - Country:US
Practice Address - Phone:917-774-7671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051395183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist