Organization
SOUTHBORO MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN C. OSTROVSKY M.D. (PRESIDENT)
(508) 481-5500
Entity
Organization
Contact information
Practice address
24 NEWTON ST, SOUTHBOROUGH, MA 01772-1215
(508) 481-5500
(508) 460-3025
Mailing address
24 NEWTON ST, SOUTHBOROUGH, MA 01772-1215
(508) 481-5500
(508) 460-3025
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
152W00000X
Optometrist
—
—
207N00000X
Dermatology Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
213E00000X
Podiatrist
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9706127
—
MA
Enumeration date
08/11/2006
Last updated
09/11/2025
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