Individual
ILEANA ORTIZ-EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1205 US ROUTE 22, PHILLIPSBURG, NJ 08865
(908) 213-2211
(908) 213-9913
Mailing address
PO BOX 758952, BALTIMORE, MD 21275-8952
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MA68294
NJ
207Q00000X
Family Medicine Physician
MD071288L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119772
MEDICARE PA
PA
05
—
8313407
—
NJ
Enumeration date
10/26/2005
Last updated
02/21/2020
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