Provider Demographics
NPI:1730135559
Name:PAUL D. OSTROVSKY, JAMES W. BRADY MDPC
Entity Type:Organization
Organization Name:PAUL D. OSTROVSKY, JAMES W. BRADY MDPC
Other - Org Name:83RD STREET RADIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:OSTROVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-879-6200
Mailing Address - Street 1:121A E 83RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0803
Mailing Address - Country:US
Mailing Address - Phone:212-879-6200
Mailing Address - Fax:212-879-8427
Practice Address - Street 1:121A E 83RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0803
Practice Address - Country:US
Practice Address - Phone:212-879-6200
Practice Address - Fax:212-879-8427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY76A391Medicare ID - Type UnspecifiedPROVIDER NUMBER