Provider Demographics
NPI:1689907917
Name:OSTROSKY, EMERY
Entity Type:Individual
Prefix:
First Name:EMERY
Middle Name:
Last Name:OSTROSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 WAVERLY DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-6944
Mailing Address - Country:US
Mailing Address - Phone:541-928-8668
Mailing Address - Fax:541-926-9462
Practice Address - Street 1:1235 WAVERLY DR SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-6944
Practice Address - Country:US
Practice Address - Phone:541-928-8668
Practice Address - Fax:541-926-9462
Is Sole Proprietor?:No
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0011049183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist