Provider Demographics
NPI:1134822737
Name:OSTROWSKI, TYLER J (MD)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:J
Last Name:OSTROWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 NEW SCOTLAND AVE
Mailing Address - Street 2:DEPARTMENT OF ENT MAIL CODE: 191
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3403
Mailing Address - Country:US
Mailing Address - Phone:518-264-5578
Mailing Address - Fax:
Practice Address - Street 1:50 NEW SCOTLAND AVE
Practice Address - Street 2:DEPARTMENT OF ENT MAIL CODE: 191
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3403
Practice Address - Country:US
Practice Address - Phone:518-264-5578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY64805390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program