1538273768 NPI number — ALEXANDRA H. OSTERMAN MSW, LICSW

Table of content: ALEXANDRA H. OSTERMAN MSW, LICSW (NPI 1538273768)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538273768 NPI number — ALEXANDRA H. OSTERMAN MSW, LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OSTERMAN
Provider First Name:
ALEXANDRA
Provider Middle Name:
H.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW, LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SMITH
Provider Other First Name:
ALEXANDRA
Provider Other Middle Name:
H.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LICSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538273768
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/30/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
925 CONWAY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01330-9772
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-774-6252
Provider Business Mailing Address Fax Number:
413-773-0477

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25 BANK ROW ST
Provider Second Line Business Practice Location Address:
FL 3
Provider Business Practice Location Address City Name:
GREENFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01301-3599
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-774-6252
Provider Business Practice Location Address Fax Number:
413-773-0477
Provider Enumeration Date:
08/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  111-323 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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