Organization
SOUTHBORO MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN 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
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
687740
TUFTS OPTOMETRY GROUP
MA
Enumeration date
11/20/2006
Last updated
08/22/2020
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