Provider Demographics
NPI:1912234725
Name:OSTEN, ILANA DEVORAH (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ILANA
Middle Name:DEVORAH
Last Name:OSTEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 ERWIN RD
Mailing Address - Street 2:APT 2439
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3843
Mailing Address - Country:US
Mailing Address - Phone:919-294-4442
Mailing Address - Fax:
Practice Address - Street 1:3602 TRAIL 23
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-5156
Practice Address - Country:US
Practice Address - Phone:919-489-7771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-16
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP12360225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist