Provider Demographics
NPI:1194713453
Name:OSTROM, ANN W (PT)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:W
Last Name:OSTROM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:W
Other - Last Name:LEFLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:690 N COFCO CENTER CT
Mailing Address - Street 2:SUITE 260
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-6462
Mailing Address - Country:US
Mailing Address - Phone:602-279-6905
Mailing Address - Fax:888-445-4263
Practice Address - Street 1:300 W CLARENDON AVE
Practice Address - Street 2:SUITE 285
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3420
Practice Address - Country:US
Practice Address - Phone:602-277-3686
Practice Address - Fax:608-277-3676
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ04512251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ982133Medicaid
Q09213Medicare UPIN
AZ113181Medicare PIN
AZ1396819546Medicare NSC
AZ1871652131Medicare NSC
AZ1265647879Medicare NSC
AZ1164581427Medicare NSC
AZ1447465059Medicare NSC
AZ1568521821Medicare NSC
AZ1831211143Medicare NSC
AZZ113264Medicare PIN