# PROMD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134677644
- **Authorized official:** DR. TELISHA ORTIZ M.D. (PHYSICIAN OWNER)
- **Authorized official phone:** (832) 567-1808

## Contact information

- **Practice address:** 608 BERKLEY ST, CAMDEN, NJ 08103-1414
- **Practice address phone:** (832) 567-1808
- **Mailing address:** 5058 CITY LINE AVE, PHILADELPHIA, PA 19131-1441

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | MD456019 | PA | Yes |

## Other

- **Enumeration date:** 09/13/2016
- **Last updated:** 09/13/2016