Provider Demographics
NPI:1932304318
Name:OSTRYNSKI, HERMINIA SARA (LPN)
Entity Type:Individual
Prefix:MS
First Name:HERMINIA
Middle Name:SARA
Last Name:OSTRYNSKI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 YOUNGS AVE
Mailing Address - Street 2:
Mailing Address - City:CALVERTON
Mailing Address - State:NY
Mailing Address - Zip Code:11933-1429
Mailing Address - Country:US
Mailing Address - Phone:631-369-7446
Mailing Address - Fax:
Practice Address - Street 1:82 YOUNGS AVE
Practice Address - Street 2:
Practice Address - City:CALVERTON
Practice Address - State:NY
Practice Address - Zip Code:11933-1429
Practice Address - Country:US
Practice Address - Phone:631-369-7446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105314164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01099861Medicaid