Provider Demographics
NPI:1649313776
Name:OSTROFF, DIANA JOY (ND, LAC)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:JOY
Last Name:OSTROFF
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5283 KIMOKEO ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-1739
Mailing Address - Country:US
Mailing Address - Phone:808-373-9966
Mailing Address - Fax:808-373-3456
Practice Address - Street 1:5283 KIMOKEO ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-1739
Practice Address - Country:US
Practice Address - Phone:808-373-9966
Practice Address - Fax:808-373-3456
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI78207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine