Provider Demographics
NPI:1538263587
Name:OSTROV, DEBORAH (PHD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:OSTROV
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HAYDEN AVE
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11024-2012
Mailing Address - Country:US
Mailing Address - Phone:516-510-4341
Mailing Address - Fax:
Practice Address - Street 1:2 HAYDEN AVE
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11024-2012
Practice Address - Country:US
Practice Address - Phone:516-510-4341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005654103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical