Provider Demographics
NPI:1871685172
Name:OSTROVSKY, TAMARA (RRT LAC)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:OSTROVSKY
Suffix:
Gender:F
Credentials:RRT LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-1160
Mailing Address - Country:US
Mailing Address - Phone:415-963-2111
Mailing Address - Fax:
Practice Address - Street 1:2320 SUTTER ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3038
Practice Address - Country:US
Practice Address - Phone:415-963-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00018243227900000X, 2279G0305X
CAAC006879171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Not Answered2279G0305XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeriatric Care
Not Answered171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2763833Medicare UPIN