Provider Demographics
NPI:1588704779
Name:OSTROFF, ROSS MATTHEW (OD)
Entity type:Individual
Prefix:DR
First Name:ROSS
Middle Name:MATTHEW
Last Name:OSTROFF
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:108 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1719
Mailing Address - Country:US
Mailing Address - Phone:267-718-9863
Mailing Address - Fax:
Practice Address - Street 1:100 E STREET RD
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-3400
Practice Address - Country:US
Practice Address - Phone:215-957-4783
Practice Address - Fax:215-675-2405
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001538152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist