Individual
DR. LARISSA S OSTROVSKAIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1914
(201) 996-2200
(201) 489-2812
Mailing address
130 KINDERKAMACK RD, SUITE 200, RIVER EDGE, NJ 07661
(201) 488-2660
(201) 489-2812
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA07088900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8345406
—
NJ
Enumeration date
12/13/2005
Last updated
09/06/2007
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