Individual
IVETTE BECERRA ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
374 GRAND AVENUE, FAIR HAVEN COMMUNITY HEALTH CTR, NEW HAVEN, CT 06513
(203) 777-7411
(203) 777-8506
Mailing address
275 WOLCOTT HILL ROAD, WEATHERSFIELD, CT 06109-2033
(860) 436-4126
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
002875
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000221420102
UNITED HEALTHCARE
—
01
—
330281
WELLCARE
—
01
—
P3598502
OXFORD
—
Enumeration date
08/21/2006
Last updated
07/08/2007
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