Provider Demographics
NPI:1710242656
Name:OSTACHOWSKY, DOREEN (LPN)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:
Last Name:OSTACHOWSKY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 W OLD FARM RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-5253
Mailing Address - Country:US
Mailing Address - Phone:914-204-1357
Mailing Address - Fax:845-592-4582
Practice Address - Street 1:3 W OLD FARM RD
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-5253
Practice Address - Country:US
Practice Address - Phone:914-204-1357
Practice Address - Fax:845-592-4582
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306358-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse