Provider Demographics
NPI:1740069764
Name:OSTROWSKI, NICHOLAS A
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:A
Last Name:OSTROWSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12122 HOOPER LN
Mailing Address - Street 2:
Mailing Address - City:GLEN ARM
Mailing Address - State:MD
Mailing Address - Zip Code:21057-9401
Mailing Address - Country:US
Mailing Address - Phone:443-425-6815
Mailing Address - Fax:
Practice Address - Street 1:12122 HOOPER LN
Practice Address - Street 2:
Practice Address - City:GLEN ARM
Practice Address - State:MD
Practice Address - Zip Code:21057-9401
Practice Address - Country:US
Practice Address - Phone:443-425-6815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program