Active NPI
Evelina Ostrov
- School Psychologist
- Staten Island, NY
National Provider Identifier
1073927760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 613405121
- Practice address
- 319 Jefferson Ave
Staten Island, NY 10306-5222 - Phone
- (917) 216-2085
- NPI assigned
- Jun 20, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 613405121 | NY | Primary |
Addresses
Primary practice location
319 Jefferson Ave
Staten Island, NY 10306-5222
Mailing address
319 Jefferson Ave
Staten Island, NY 10306-5222
Phone (917) 216-2085
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 613405121 | NY | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403222400000",
"number": "1073927760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "319 JEFFERSON AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103065222",
"telephone_number": "917-216-2085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "319 JEFFERSON AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103065222",
"telephone_number": "917-216-2085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSTROV",
"first_name": "EVELINA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-20",
"last_updated": "2014-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NY",
"license": "613405121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.