# HEALTHSTAR MEDICAL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548236094
- **Authorized official:** DR. LADA OSIPOVA D.O (PRESIDENT)
- **Authorized official phone:** (631) 321-1286

## Contact information

- **Practice address:** 747 MONTAUK HIGHWAY, WEST ISLIP, NY 11795
- **Practice address phone:** (631) 321-1286
- **Practice address fax:** (631) 321-1379
- **Mailing address:** 747 MONTAUK HIGHWAY, WEST ISLIP, NY 11795
- **Mailing address phone:** (631) 321-1286
- **Mailing address fax:** (631) 321-1379

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/24/2006
- **Last updated:** 05/13/2009